Author Of 1 Presentation
EXTUBATION CHARACTERISTICS OF EXTREMELY PRETERM INFANTS
Abstract
Background
Predicting which extremely preterm infants (EPI, <28 weeks’) will be successfully extubated to non-invasive ventilation is difficult. We aimed to compare the characteristics and outcomes of EPI who had extubation success and failure.
Objectives
To understand the differences in infants who are unsuccessfully extubated from invasive mechanical ventilation compared to their successfully extubated counterparts.
Methods
Dual centre retrospective audit of the first extubation of EPI conducted between 2016-2017. Extubation failure was defined as reintubation within 7 days.
Results
one hundred of 198 (50.51%) EPI required reintubation. There were important differences in the characteristics of infants in both groups. Infants requiring reintubation had poorer outcomes than those who did not (table). In a multivariable regression model GA remained the only significant predictor of extubation success (area under a receiver operating characteristic curve = 0.73).
| Demographic | Success (n=98) | Failure (n=100) | P |
| Gestational age in weeks (mean, SD) | 26.5 (1.1) | 25.6 (0.9) | <0.001 |
| Birth-weight, in grams (mean, SD) | 901 (179) | 771 (157) | 0.001 |
| Pre-extubation MAP (mmHg) | 7.6 (1.6) | 8.6 (1.5) | 0.003 |
| Pre-extubation achieved VT (mL/kg)• | 4.2(3.3-4.8) | 3.7 (2.9-4.2) | 0.023 |
| Outcomes | |||
| Use of postnatal corticosteroids | 4(9%) | 16(37%) | 0.001 |
| BPD at 36 weeks PMA | 18(40%) | 33(80%) | 0.008* |
| Supplemental O2 (days) in survivor | 76.5 (28.6) | 123.3 (41.9) | 0.001 |
| Hospitalization (days) in survivors | 88.9 (29.1) | 130.9 (40.4) | 0.001 |
Conclusion
Lower GA and birthweight and greater ventilator support are associated with an increased risk of extubation failure. Failure is associated with longer durations of supplemental oxygen and hospitalisation and an increased risk of BPD.