부산대학교 도서관

Aim: To determine predictors and outcomes of extubation failure in extremely preterm (EP) infants born <28 weeks' gestational age (GA). Methods: Retrospective clinical audit across two tertiary‐level neonatal intensive care units in Melbourne, Australia. Two‐hundred and four EP infants who survived to their first extubation from mechanical ventilation. Extubation failure (re‐intubation) within 7 days after the first extubation. Results: Lower GA (odds ratio [OR] 0.71, 95% confidence interval (CI), 0.61–0.89, P < 0.001) and higher pre‐extubation measured mean airway pressure (MAP) on the mechanical ventilator (OR 1.9 [95% CI 1.41–2.51], P < 0.001) predicted extubation failure. The area under a receiver operating characteristic curve for GA and MAP was 0.77 (95% CI 0.70–0.82). After adjustment for GA, infants who experienced extubation failure had higher rates of bronchopulmonary dysplasia (P < 0.001), post‐natal systemic corticosteroid treatment (P < 0.001), airway trauma (P < 0.003), longer durations of treatment with mechanical ventilation (P < 0.001), non‐invasive respiratory support (P < 0.001), supplemental oxygen therapy (P = 0.05) and longer hospitalisation (P = 0.025). Conclusions: Lower GA and higher pre‐extubation measured MAP were predictive of extubation failure within 7 days in extremely preterm infants. Extubation failure was associated with increased morbidity and extended periods of respiratory support and hospitalisation. [ABSTRACT FROM AUTHOR]