Predictors of Extubation Success in Extremely Low Birth Weight (ELBW) Infants

Objective. To evaluate the value of pre-extubation blood gas parameters, ventilatory settings and nutritional status as predictors of extubation success in extremely low birth weight (ELBW) infants. Methods. Secondary data analysis was performed on a prospective cohort of 161 ELBW infants enrolled in a randomized trial, which compared two nasal continuous positive airway pressure (CPAP) systems for extubation success. Interventions: none. Extubation failure was defined as the need for reintubation within 7 days. Logistic regression models were used to identify clinical predictors of extubation success. Results. Sixty-one infants met criteria for extubation failure and 100 infants met criteria for extubation success. Extubation success was associated with older chronological age (p=0.01), longer duration of intubation (p=0.01) and higher mean extubation weight (p=0.03). The final logistic regression model retained three parameters with significance for extubation success: gestational age, blood pH and total calories on the day of first extubation attempt. Conclusion. Older age, better nutrition and higher blood pH and bicarbonate are associated with extubation success. No other blood gas parameters and no ventilatory settings parameters can reliably predict extubation outcome in ELBW infants. Even the smallest category of infants with birth weight less than 600 g had 50% chance of successful extubation using the suggested extubation guidelines.

Grantor dc:publisher

Wake Forest University

Year dc:date.issued

2009

Author dc:creator

• Stefanescu, Beatrice

• predictors

Language dc:language.iso

en_US

Handle dc:identifier.uri

http://hdl.handle.net/10339/14655

OAI identifier oai:identifier

oai:wakespace.lib.wfu.edu:10339/14655