Factors associated with extubation failure in very low birth weight infants: a cohort study in the northeast Brazil.

Autor:	Teixeira RF; Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil.; CESMAC University Centre, Maceió, Alagoas, Brazil.; Santa Monica Maternity School Hospital, Maceió, Alagoas, Brazil., Costa CM; Santa Monica Maternity School Hospital, Maceió, Alagoas, Brazil., Maria de Abreu C; CESMAC University Centre, Maceió, Alagoas, Brazil., Lessa CA; CESMAC University Centre, Maceió, Alagoas, Brazil., Carvalho AC; CESMAC University Centre, Maceió, Alagoas, Brazil., Kassar SB; CESMAC University Centre, Maceió, Alagoas, Brazil., Barreto ID; Federal Rural University of Pernambuco, Recife, Brazil., Gurgel RQ; Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil., Medeiros AM; Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of perinatal medicine [J Perinat Med] 2020 Dec 18; Vol. 49 (4), pp. 506-513. Date of Electronic Publication: 2020 Dec 18 (Print Publication: 2021).
DOI:	10.1515/jpm-2020-0313
Abstrakt:	Objectives: Identifying and understanding the main risk factors associated with extubation failure of very low birthweight (VLBW) infants in different populations can subsequently help in establishing better criteria while taking decision of extubation. The aim of the study was to identify factors associated with extubation failure in VLBW infants. Methods: A cohort study of VLBW infants who underwent their first extubation between April 2018 and December 2019 in a Neonatal Intensive Care Unit, Alagoas, Brazil, were included in this study. Extubation failure was defined as reintubation within seven days of extubation. Relative risks of predictive variables different between the extubation success group (ES) and extubation failure group (EF) were estimated with a robust Poisson regression model. Results: Out of the 112 infants included, 26 (23%) cases exhibited extubation failure. Extremely low birth weight (RR 2.55, 95% CI 1.07, 6.06), mechanical ventilation duration for first extubation greater than seven days (RR 2.66, 95% CI 1.10, 6.45), vaginal delivery (RR 2.07, 95% CI 1.03, 4.18) and maternal chorioamnionitis (RR 4.89, 95% CI 1.26-18.98) remained independently associated with extubation failure. EF had a significant greater need for respiratory support, longer oxygen therapy duration, more bronchopulmonary dysplasia (BPD) and longer length of hospital stay, even when adjusted for confounding variables. Conclusions: Extremely low birth weight infants needing mechanical ventilation, wherein the duration for first extubation was longer than seven days, with vaginal delivery and maternal chorioamnionitis failed more frequently at the first attempt of extubation. And this failure increased the risk of BPD and the length of hospital stay. (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)
Databáze:	MEDLINE
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