Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.
Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
Am J Perinatol. 2020 Jan;37(2):204-209. doi: 10.1055/s-0039-1696714. Epub 2019 Sep 6.
To compare the adjusted and unadjusted-for-weight tidal volume (V) in ventilated prematurely born infants who were successfully extubated compared with the ones who failed extubation and explore the ability of V to predict successful extubation.
This is a two-center, prospective, observational, cohort study of ventilated infants born <32 weeks of gestational age (GA) at King's College Hospital and St George's University Hospital, London, United Kingdom between February and September 2018. Expiratory V was recorded before extubation, and extubation was considered successful if the infants were not reintubated within 72 hours.
Fifty-six (29 male) infants with a median (interquartile range) GA of 26 (25-29) weeks were studied. The infants who successfully extubated ( = 36) had a higher GA (27 [25-30] weeks) and V (7.2 [4.8-9.5] mL) compared with the GA (25 [24-26] weeks) and V (4.3 [4.0-5.5] mL) of the infants who failed extubation ( = 0.002 and = 0.001, respectively). V/kg was not different in infants who successfully extubated compared with the ones who failed extubation ( = 0.643). Following multivariate regression, V was associated with extubation success (adjusted = 0.022) and GA was not (adjusted = 0.167). A V > 4.5 mL predicted successful extubation with 82% sensitivity and 58% specificity (area under the curve = 0.786).
Successful extubation was associated with higher unadjusted-for-weight Vs compared with failed extubation, and unadjusted V predicted extubation outcome with moderate sensitivity and specificity.
比较成功撤机和撤机失败的早产儿的调整和未调整体重潮气容积（V），并探讨 V 预测撤机成功的能力。
这是一项在英国伦敦国王学院医院和圣乔治大学医院进行的二中心、前瞻性、观察性、队列研究。在 2018 年 2 月至 9 月期间，对出生胎龄（GA）<32 周的接受通气的婴儿进行了呼气末 V 的记录，并且如果婴儿在 72 小时内未重新插管，则认为撤机成功。
研究共纳入了 56 名（男婴 29 名）婴儿，中位（四分位间距）GA 为 26（25-29）周。与撤机失败的婴儿（n=0.002 和 n=0.001）相比，成功撤机的婴儿（n=36）GA 更高（27[25-30]周）、V 更大（7.2[4.8-9.5]mL）。成功撤机的婴儿的 V/kg 与撤机失败的婴儿无差异（n=0.643）。多元回归后，V 与撤机成功相关（调整后 = 0.022），而 GA 则不相关（调整后 = 0.167）。V>4.5 mL 预测撤机成功的敏感性为 82%，特异性为 58%（曲线下面积 = 0.786）。
与撤机失败相比，成功撤机与未调整体重 V 更高相关，且未调整 V 对撤机结局具有中等的敏感性和特异性。
