Risk factors associated with failure of extubation in very-low-birth-weight newborns

摘要

Aim: To identify risk factors associated with the failure of extubation of mechanically ventilated very-low-birth-weight newborns.Study design: Prospective observational study. Assessment of the occurrence of extubation failure in relation to demographic and ventilation parameters, the SpO(2)/FiO(2) ratio, the spontaneous breathing test (SBT) and values of the Silverman-Andersen score (SAS). Extubation failure was defined as the need for reintubation for any reason within 72h after extubation.Results: Extubation failed in 14/50 (28%) patients. Tidal volume applied at the moment of extubation (p=0.030), the values of the SpO(2)/FiO(2) ratio (p=0.006), SBT (p=0.034) and SAS measured for 60min after extubation and later (p=0.010, p=0.000001, p approximate to 0.000, respectively) showed a significant association with reintubation.Conclusions: Measured TV, SpO(2)/FiO(2) ratio, SBT at the moment of extubation and values of SAS starting 1h after extubation might be valuable parameters in identifying those VLBW newborns in the risk to fail extubation.