早产儿拔管时间与拔管成功率的相关性：一项多中心队列研究。
Association of time of day and extubation success in very low birthweight infants: a multicenter cohort study.
机构信息
Meharry Medical College, Nashville, TN, USA.
Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
J Perinatol. 2021 Oct;41(10):2532-2536. doi: 10.1038/s41372-021-01168-6. Epub 2021 Jul 24.
OBJECTIVE
To determine the association of overnight extubation (OE) with extubation success.
STUDY DESIGN
Retrospective cohort study in three NICUs from 2016 to 2020. Infants without congenital anomalies, less than 1500 grams at birth, who were ventilated and received an extubation attempt were included. Primary exposure was OE (7:00 pm-6:59 am) and outcome was extubation success defined as no mechanical ventilation for at least 7 days after extubation.
RESULTS
A total of 76/379 (20%) infants received OE. Infants extubated during the daytime were older and had higher illness severity markers. Extubation success rates did not differ for overnight (57/76, 75%) versus daytime extubations (231/303, 76%) after adjusting for confounders (adjusted relative risk 0.95, 95% CI 0.82-1.11).
CONCLUSION
Though infants in our cohort undergoing daytime and OE were dissimilar, extubation success rates did not differ. Larger multicenter studies are needed to test our findings and identify markers of extubation readiness in preterm infants.
目的
确定夜间拔管（OE）与拔管成功的关系。
研究设计
2016 年至 2020 年在三个 NICU 进行的回顾性队列研究。纳入无先天性异常、出生体重小于 1500 克、接受通气并尝试拔管的婴儿。主要暴露因素为 OE（晚上 7:00-早上 6:59），结局为拔管成功，定义为拔管后至少 7 天无需机械通气。
结果
共有 76/379（20%）名婴儿接受 OE。白天拔管的婴儿年龄更大，疾病严重程度标志物更高。在调整混杂因素后，夜间（57/76，75%）与白天（231/303，76%）拔管的成功率没有差异（校正相对风险 0.95，95%CI 0.82-1.11）。
结论
尽管我们队列中接受日间和 OE 的婴儿存在差异，但拔管成功率没有差异。需要更大规模的多中心研究来检验我们的发现，并确定早产儿拔管准备的标志物。
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