Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Neonatal Intensive Care Unit, University of Ioannina, Faculty of Medicine, Ioannina, Greece.
J Perinatol. 2024 Feb;44(2):250-256. doi: 10.1038/s41372-023-01849-4. Epub 2023 Dec 20.
To identify variables associated with extubation success in extremely preterm neonates extubated from invasive volume-targeted ventilation.
We retrospectively evaluated 84 neonates ≤28 weeks' gestational age, on their first elective extubation. The primary outcome of successful extubation was defined as non-reintubation within seven days. We used multivariate logistic regression analysis.
We identified 58 (69%) neonates (mean gestational age of 26.5 ± 1.4 weeks, birthweight 921 ± 217 g) who met the primary outcome. Female sex (OR 1.15, 95% CI 1.01-9.10), higher pre-extubation weight (OR 1.29, 95% CI 1.05-1.59), and pH (OR 2.54, 95% CI 1.54-4.19), and lower pre-extubation mean airway pressure (MAP) (OR 0.49, 95% CI 0.33-0.73) were associated with successful extubation.
In preterm neonates, female sex, higher pre-extubation weight and pH, and lower pre-extubation MAP were predictors of successful extubation from volume-targeted ventilation. Evaluation of these variables will likely assist clinicians in selecting the optimal time for extubation in such vulnerable neonates.
确定与接受容量目标性通气的极早产儿拔管成功相关的变量。
我们回顾性评估了 84 名胎龄≤28 周、首次择期拔管的新生儿。成功拔管的主要结局定义为 7 天内无需再次插管。我们使用多变量逻辑回归分析。
我们确定了 58 名（69%）符合主要结局的新生儿（平均胎龄 26.5±1.4 周，出生体重 921±217g）。女性（OR 1.15，95%CI 1.01-9.10）、较高的拔管前体重（OR 1.29，95%CI 1.05-1.59）、较高的 pH 值（OR 2.54，95%CI 1.54-4.19）和较低的拔管前平均气道压（MAP）（OR 0.49，95%CI 0.33-0.73）与拔管成功相关。
在早产儿中，女性、较高的拔管前体重和 pH 值以及较低的拔管前 MAP 是容量目标性通气拔管成功的预测因素。评估这些变量可能有助于临床医生为这些脆弱的新生儿选择最佳的拔管时机。
