Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada
Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island, USA.
Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):105-112. doi: 10.1136/archdischild-2020-321282. Epub 2021 Feb 24.
In the modern era of neonatology, mechanical ventilation has been restricted to a smaller and more immature population of extremely preterm infants. Given the adverse outcomes associated with mechanical ventilation, every effort is made to extubate these infants as early as possible. However, the scientific basis for determining extubation readiness remains imprecise and primarily guided by clinical judgement, which is highly variable and subjective. In the absence of accurate tools to assess extubation readiness, many infants fail their extubation attempt and require reintubation, which also increases complications. Recent advances in the field have led to unravelling some of the complexities surrounding extubation in this population. This review aims to synthesise the available knowledge and provide a more evidence-based approach towards the reporting of extubation outcomes and assessment of extubation readiness in extremely preterm infants.
在新生儿医学的现代时代，机械通气已仅限于非常早产儿的更小和更不成熟的人群。鉴于机械通气相关的不良后果，尽一切努力尽早为这些婴儿拔管。然而，确定拔管准备情况的科学依据仍然不精确，主要由临床判断指导，而临床判断差异很大且主观。在缺乏评估拔管准备情况的准确工具的情况下，许多婴儿拔管尝试失败，需要重新插管，这也会增加并发症。该领域的最新进展揭示了与该人群拔管相关的一些复杂性。本综述旨在综合现有知识，并为极早产儿的拔管结果报告和拔管准备情况评估提供更具循证依据的方法。
