Predictors of successful extubation from volume-targeted ventilation in extremely preterm neonates. 2024

Dimitrios Rallis, and Danielle Ben-David, and Kendra Woo, and Jill Robinson, and David Beadles, and Fotios Spyropoulos, and Helen Christou, and Sule Cataltepe
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. drallis@uoi.gr.

OBJECTIVE To identify variables associated with extubation success in extremely preterm neonates extubated from invasive volume-targeted ventilation. METHODS We retrospectively evaluated 84 neonates ≤28 weeks' gestational age, on their first elective extubation. The primary outcome of successful extubation was defined as non-reintubation within seven days. We used multivariate logistic regression analysis. RESULTS We identified 58 (69%) neonates (mean gestational age of 26.5 ± 1.4 weeks, birthweight 921 ± 217 g) who met the primary outcome. Female sex (OR 1.15, 95% CI 1.01-9.10), higher pre-extubation weight (OR 1.29, 95% CI 1.05-1.59), and pH (OR 2.54, 95% CI 1.54-4.19), and lower pre-extubation mean airway pressure (MAP) (OR 0.49, 95% CI 0.33-0.73) were associated with successful extubation. CONCLUSIONS In preterm neonates, female sex, higher pre-extubation weight and pH, and lower pre-extubation MAP were predictors of successful extubation from volume-targeted ventilation. Evaluation of these variables will likely assist clinicians in selecting the optimal time for extubation in such vulnerable neonates.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D060666 Airway Extubation Removal of an endotracheal tube from the patient. Endotracheal Extubation,Extubation, Intratracheal,Tracheal Extubation,Airway Extubations,Endotracheal Extubations,Extubation, Airway,Extubation, Endotracheal,Extubation, Tracheal,Extubations, Airway,Extubations, Endotracheal,Extubations, Intratracheal,Extubations, Tracheal,Intratracheal Extubation,Intratracheal Extubations,Tracheal Extubations
D062071 Infant, Extremely Premature A human infant born before 28 weeks of GESTATION. Extremely Premature Infants,Extremely Preterm Infants,Extremely Premature Infant,Extremely Preterm Infant,Infant, Extremely Preterm,Infants, Extremely Premature,Infants, Extremely Preterm,Premature Infant, Extremely,Premature Infants, Extremely,Preterm Infant, Extremely,Preterm Infants, Extremely

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