{"title":"极低和极低出生体重早产儿拔管成功的预测因素。","authors":"Nilson Willamy Bastos de Souza Júnior, Tathiane Ribeiro Rosa, Jane Cecília Kreling Cerântola, Ligia Silvana Lopes Ferrari, Vanessa Suziane Probst, Josiane Marques Felcar","doi":"10.29390/001c.87789","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although invasive mechanical ventilation (IMV) has contributed to the survival of preterm infants with extremely low birth weight (ELBW), it is also associated with unsatisfactory clinical outcomes when used for prolonged periods. This study aimed to identify factors that may be decisive for extubation success in very low birth weight (VLBW) and extremely low birth weight (ELBW) preterm infants.</p><p><strong>Methods: </strong>The cohort study included preterm infants with gestational age (GA) <36 weeks, birth weight (BW) <1500 grams who underwent IMV, born between 2015 and 2018. The infants were allocated into two groups: extubation success (SG) or failure (FG). A stepwise logistic regression model was created to determine variables associated with successful extubation.</p><p><strong>Results: </strong>Eighty-three preterm infants were included. GA and post-extubation arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>) were predictive of extubation success. Infants from FG had lower GA and BW, while those from SG had higher weight at extubation and lower post-extubation PaCO<sub>2</sub>.</p><p><strong>Discussion: </strong>Although we found post-extubation PaCO<sub>2</sub> as an extubation success predictor, which is a variable representative of the moment after the primary outcome, this does not diminish its clinical relevance since extubation does not implicate in ET removal only; it also involves all the aspects that take place within a specified period (72 hours) after the planned event.</p><p><strong>Conclusion: </strong>GA and post-extubation PaCO<sub>2</sub> were predictors for extubation success in VLBW and ELBW preterm infants. Infants who experienced extubation failure had lower birth weight and higher FiO<sub>2</sub> prior to extubation.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"204-213"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/7a/cjrt_2023_59_87789.PMC10540158.pdf","citationCount":"0","resultStr":"{\"title\":\"Predictive factors for extubation success in very low and extremely low birth weight preterm infants.\",\"authors\":\"Nilson Willamy Bastos de Souza Júnior, Tathiane Ribeiro Rosa, Jane Cecília Kreling Cerântola, Ligia Silvana Lopes Ferrari, Vanessa Suziane Probst, Josiane Marques Felcar\",\"doi\":\"10.29390/001c.87789\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although invasive mechanical ventilation (IMV) has contributed to the survival of preterm infants with extremely low birth weight (ELBW), it is also associated with unsatisfactory clinical outcomes when used for prolonged periods. This study aimed to identify factors that may be decisive for extubation success in very low birth weight (VLBW) and extremely low birth weight (ELBW) preterm infants.</p><p><strong>Methods: </strong>The cohort study included preterm infants with gestational age (GA) <36 weeks, birth weight (BW) <1500 grams who underwent IMV, born between 2015 and 2018. The infants were allocated into two groups: extubation success (SG) or failure (FG). A stepwise logistic regression model was created to determine variables associated with successful extubation.</p><p><strong>Results: </strong>Eighty-three preterm infants were included. GA and post-extubation arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>) were predictive of extubation success. Infants from FG had lower GA and BW, while those from SG had higher weight at extubation and lower post-extubation PaCO<sub>2</sub>.</p><p><strong>Discussion: </strong>Although we found post-extubation PaCO<sub>2</sub> as an extubation success predictor, which is a variable representative of the moment after the primary outcome, this does not diminish its clinical relevance since extubation does not implicate in ET removal only; it also involves all the aspects that take place within a specified period (72 hours) after the planned event.</p><p><strong>Conclusion: </strong>GA and post-extubation PaCO<sub>2</sub> were predictors for extubation success in VLBW and ELBW preterm infants. Infants who experienced extubation failure had lower birth weight and higher FiO<sub>2</sub> prior to extubation.</p>\",\"PeriodicalId\":39373,\"journal\":{\"name\":\"Canadian Journal of Respiratory Therapy\",\"volume\":\"59 \",\"pages\":\"204-213\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/7a/cjrt_2023_59_87789.PMC10540158.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Respiratory Therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.29390/001c.87789\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"0\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Respiratory Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29390/001c.87789","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"0","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Predictive factors for extubation success in very low and extremely low birth weight preterm infants.
Background: Although invasive mechanical ventilation (IMV) has contributed to the survival of preterm infants with extremely low birth weight (ELBW), it is also associated with unsatisfactory clinical outcomes when used for prolonged periods. This study aimed to identify factors that may be decisive for extubation success in very low birth weight (VLBW) and extremely low birth weight (ELBW) preterm infants.
Methods: The cohort study included preterm infants with gestational age (GA) <36 weeks, birth weight (BW) <1500 grams who underwent IMV, born between 2015 and 2018. The infants were allocated into two groups: extubation success (SG) or failure (FG). A stepwise logistic regression model was created to determine variables associated with successful extubation.
Results: Eighty-three preterm infants were included. GA and post-extubation arterial partial pressure of carbon dioxide (PaCO2) were predictive of extubation success. Infants from FG had lower GA and BW, while those from SG had higher weight at extubation and lower post-extubation PaCO2.
Discussion: Although we found post-extubation PaCO2 as an extubation success predictor, which is a variable representative of the moment after the primary outcome, this does not diminish its clinical relevance since extubation does not implicate in ET removal only; it also involves all the aspects that take place within a specified period (72 hours) after the planned event.
Conclusion: GA and post-extubation PaCO2 were predictors for extubation success in VLBW and ELBW preterm infants. Infants who experienced extubation failure had lower birth weight and higher FiO2 prior to extubation.
期刊介绍:
The CJRT is published four times a year and represents the interests of respiratory therapists nationally and internationally. The CJRT has been redesigned to act as an educational dissemination tool. The CJRT encourages submission of original articles, papers, commentaries, case studies, literature reviews and directed reading papers. Submissions can be sent to Rita Hansen.