Iyer Narayan P, Dickson John, Ruiz Michelle E, Chatburn Robert, Beck Jennifer, Sinderby Chister, Rodriguez Ricardo J
Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
Department of Critical Care, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada.
Acta Paediatr. 2017 Dec;106(12):1928-1933. doi: 10.1111/apa.14040. Epub 2017 Sep 12.
To describe the neural breathing pattern before and after extubation in newborn infants.
Prospective, observational study. In infants deemed ready for extubation, the diaphragm electrical activity (EAdi) was continuously recorded from 30 minute before to two hours after extubation.
Total of 25 neonates underwent 29 extubations; 10 extubations resulted in re-intubation within 72 hours. Postextubation, there was an increase in peak EAdi (EAdi-max) and EAdi-delta (peak minus minimum EAdi) in both groups. The pre- to postextubation change in EAdi-max (8.9-11.1 μv) and EAdi-delta (6-8 μv) was less in the failure group in comparison with the change in EAdi-max (10.2-13.4 μv) and EAdi-delta (6.3-10.6 μv) in the success group, (p = 0.02 and 0.01, respectively).
In our neonatal cohort, extubation failure was associated with a smaller increase in peak and delta EAdi after extubation. If confirmed, these findings indicate an important cause of extubation failure in preterm infants.
描述新生儿拔管前后的神经呼吸模式。
前瞻性观察研究。对于被认为准备好拔管的婴儿，在拔管前30分钟至拔管后两小时持续记录膈肌电活动（EAdi）。
共有25例新生儿接受了29次拔管；10次拔管导致在72小时内再次插管。拔管后，两组的EAdi峰值（EAdi-max）和EAdi差值（峰值减去最小EAdi）均增加。与成功组的EAdi-max（10.2 - 13.4 μv）和EAdi差值（6.3 - 10.6 μv）变化相比，失败组的拔管前后EAdi-max（8.9 - 11.1 μv）和EAdi差值（6 - 8 μv）变化较小（p分别为0.02和0.01）。
在我们的新生儿队列中，拔管失败与拔管后EAdi峰值和差值的较小增加有关。如果得到证实，这些发现表明了早产儿拔管失败的一个重要原因。
