Reintubation rates after extubation to different non-invasive ventilation modes in preterm infants

Autor: Prem Chandra, Amr M. Khalil, Nuha A. M. A. Nimeri, Samer Hammoudeh, Lisa J. Langtree, Nazla Mahmoud, Olfa Koobar, Alaa Masry, Nasir Mohammed, Mohammad A A Bayoumi, Einas E Elmalik
Rok vydání: 2021
Předmět:
Neonatal intensive care unit
Respiratory distress syndrome
medicine.medical_treatment
Birth weight
Nasal continuous positive airway pressure
medicine.disease_cause
Pediatrics
RJ1-570
03 medical and health sciences
Reintubation
0302 clinical medicine
030225 pediatrics
Intubation
Intratracheal
Medicine
Humans
030212 general & internal medicine
Continuous positive airway pressure
Qatar
Retrospective Studies
Respiratory Distress Syndrome
Newborn
Noninvasive Ventilation
Respiratory distress
Continuous Positive Airway Pressure
business.industry
Vaginal delivery
Research
Infant
Newborn
Gestational age
Infant
Retrospective cohort study
Nasal intermittent positive pressure ventilation
Newborn
Anesthesia
Pediatrics
Perinatology and Child Health
Airway Extubation
Female
business
Nasal cannula
Infant
Premature
Zdroj: BMC Pediatrics
BMC Pediatrics, Vol 21, Iss 1, Pp 1-12 (2021)
ISSN: 1471-2431
Popis: IntroductionRespiratory Distress Syndrome (RDS) is a common cause of neonatal morbidity and mortality in premature newborns. In this study, we aim to compare the reintubation rate in preterm babies with RDS who were extubated to Nasal Continuous Positive Airway Pressure (NCPAP) versus those extubated to Nasal Intermittent Positive Pressure Ventilation (NIPPV).MethodsThis is a retrospective study conducted in the Neonatal Intensive Care Unit (NICU) of Women’s Wellness and Research Center (WWRC), Doha, Qatar. The medical files (n = 220) of ventilated preterm infants with gestational age ranging between 28 weeks 0 days and 36 weeks + 6 days gestation and extubated to non-invasive respiratory support (whether NCPAP, NIPPV, or Nasal Cannula) during the period from January 2016 to December 2017 were reviewed.ResultsFrom the study group of 220 babies,n = 97 (44%) babies were extubated to CPAP,n = 77 (35%) were extubated to NIPPV, andn = 46 (21%) babies were extubated to Nasal Cannula (NC). Out of then = 220 babies, 18 (8.2%) were reintubated within 1 week after extubation. 14 of the 18 (77.8%) were reintubated within 48 h of extubation. Eleven babies needed reintubation after being extubated to NCPAP (11.2%) and seven were reintubated after extubation to NIPPV (9.2%), none of those who were extubated to NC required reintubation (P = 0.203). The reintubation rate was not affected by extubation to any form of non-invasive ventilation (P = 0.625). The mode of ventilation before extubation does not affect the reintubation rate (P = 0.877). The presence of PDA and NEC was strongly associated with reintubation which increased by two and four-folds respectively in those morbidities. There is an increased risk of reintubation with babies suffering from NEC and BPD and this was associated with an increased risk of hospital stay with aP-value ranging (from 0.02–0.003). Using multivariate logistic regression, NEC the NEC (OR = 5.52, 95% CI 1.26, 24.11,P = 0.023) and the vaginal delivery (OR = 0.23, 95% CI 0.07, 0.78,P = 0.018) remained significantly associated with reintubation.ConclusionReintubation rates were less with NIPPV when compared with NCPAP, however, this difference was not statistically significant. This study highlights the need for further research studies with a larger number of neonates in different gestational ages birth weight categories. Ascertaining this information will provide valuable data for the factors that contribute to re-intubation rates and influence the decision-making and management of RDS patients in the future.
Databáze: OpenAIRE
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