Optimising success of neonatal extubation: Respiratory support

IF 2.9 3区医学 Q1 PEDIATRICS

Seminars in Fetal & Neonatal Medicine Pub Date : 2023-10-01 DOI:10.1016/j.siny.2023.101491

Vincent D. Gaertner , Christoph M. Rüegger

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引用次数: 1

Abstract

In this review, we examine lung physiology before, during and after neonatal extubation and propose a three-phase model for the extubation procedure. We perform meta-analyses to compare different modes of non-invasive respiratory support after neonatal extubation and based on the findings, the following clinical recommendations are made:

1)
Continuous positive airway pressure support (CPAP) remains standard of care for most extubations.
2)
For high-risk infants <28 weeks' gestation or infants with expected cardiorespiratory instability, either NIPPV or nHFOV may be used as post-extubation respiratory support. Synchronized, ventilator-generated NIPPV may be more effective than alternative modes. The use of nHFOV after extubation seems to confer the largest benefit but clinical experience is limited in most centres.
3)
If backup CPAP is available, high-flow therapy may be preferred for infants ≥28 weeks with a low fraction of inspired oxygen.

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优化新生儿拔管的成功:呼吸支持。

在这篇综述中，我们检查了新生儿拔管之前，期间和之后的肺生理，并提出了拔管过程的三个阶段模型。我们进行荟萃分析，比较新生儿拔管后不同模式的无创呼吸支持，并根据研究结果，提出以下临床建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Fetal & Neonatal Medicine 医学-小儿科

CiteScore

6.40

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists. The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician. Each topic-based issue is edited by an authority in their field and contains 8-10 articles. Seminars in Fetal & Neonatal Medicine provides: • Coverage of major developments in neonatal care; • Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field; • Up-to-date information in an attractive and relevant format.