Nasotracheal intubation (NTI) is feasible and safe in neonatal cardiac surgery. System-level engagement with stakeholders is necessary to change clinical practice. NTI facilitates early SLP evaluation and treatment and significantly affects oral readiness after neonatal cardiac surgery.

Data were collected between January 2019 and April 2021.

The study was implemented in three phases: retrospective: orotracheal intubation (OTI) neonates (n = 43), I: safety and feasibility of NTI (n = 17), and II: speech language pathology (SLP) evaluation on postoperative day 1 facilitated by NTI (n = 70).

Retrospective and phase I patients were combined for analysis.

Groups were compared using Kruskal-Wallis test or Wilcoxon rank-sum test.

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