A predictive model for extubation readiness in extremely preterm infants

J Perinatol. 2019 Dec;39(12):1663-1669. doi: 10.1038/s41372-019-0475-x. Epub 2019 Aug 27.

Abstract

Objective: To develop an estimator for predicting successful extubation for an individual preterm infant.

Study design: This was a retrospective study that included infants with birth weights ≤1250 g, who were admitted to a tertiary NICU over a 7-year period, received mechanical ventilation and had an elective extubation attempt within 60 days of age. Perinatal and periextubation characteristics were compared in the successful and failed extubation groups.

Results: Of 621 screened infants, 312 were included. Extubation succeeded in 73% and failed in 27%. Adjusted factors associated with successful extubation included greater gestational age, chronologic age, pre-extubation pH and lower pre-extubation FiO2, along with lower "peak" respiratory severity score in the first 6 h of age.

Conclusions: We used readily available demographic and clinical data to create an extubation readiness estimator that provides the probability of extubation success for an individual preterm infant (http://elasticbeanstalk-us-east-2-676799334712.s3-website.us-east-2.amazonaws.com/).

MeSH terms

  • Airway Extubation*
  • Female
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Respiration, Artificial
  • Retrospective Studies
  • Treatment Outcome