Risk factors associated with extubation failure in preterm infants with very low birth weight
| Autor: | Dmytro Dobryanskyy, Anna Menshykova |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty Respiratory distress business.industry Obstetrics medicine.medical_treatment Incidence (epidemiology) Birth weight Metabolic acidosis medicine.disease Antenatal steroid 03 medical and health sciences Low birth weight 0302 clinical medicine Intraventricular hemorrhage 030225 pediatrics Anesthesia Pediatrics Perinatology and Child Health Medicine 030212 general & internal medicine medicine.symptom business |
| Zdroj: | Pediatria Polska. 92:22-27 |
| ISSN: | 0031-3939 |
| DOI: | 10.1016/j.pepo.2016.10.005 |
| Popis: | Repeated endotracheal intubation is associated with complications and additional risks for a preterm infant. The aim of this study was to determine the risk factors related to extubation failure (EF) in preterm newborns. Materials and methods Ninety two very preterm infants with respiratory distress syndrome (RDS), birth weight of Results Infants from the main group differed by lower antenatal steroid administration rate, higher incidence of intraventricular hemorrhage, severe RDS, arterial hypotension, metabolic acidosis, and pulmonary bleeding, as well as by the need in higher initial mechanical ventilation settings. According to logistic regression analysis the risk of EF was significantly associated with severe RDS (OR – 3.82; 95% CI: 1.21–12.02), arterial hypotension (OR – 24.05; 95% CI: 1.99–290.48) or metabolic acidosis (OR – 4.62; 95% CI: 1.41–15.16) in the first 3 days of life. Antenatal steroid prophylaxis considerably decreased the probability of EF (OR – 0.2; 95% CI: 0.063–0.68). Conclusions The risk of reintubation after primary extubation is determined by severe RDS, arterial hypotension or metabolic acidosis during the first 3 days of life. Antenatal steroid prophylaxis substantially decreases this risk. The method of non-invasive respiratory support following primary extubation does not influence the reintubation risk. |
| Databáze: | OpenAIRE |
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