TY - JOUR
T1 - Tidal volumes and outcome of extubation in mechanically ventilated premature infants
T2 - Extubation tidal volumes in premature infants
AU - Dassios, Theodore
AU - Williams, Emma
AU - Ambulkar, Hemant
AU - Shetty, Sandeep
AU - Hickey, Ann
AU - Greenough, Anne
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objectives To compare the adjusted and unadjusted-for-weight tidal volume (V
T) in ventilated prematurely born infants who were successfully extubated compared with the ones who failed extubation and explore the ability of V
T to predict successful extubation. Study Design This is a two-center, prospective, observational, cohort study of ventilated infants born <32 weeks of gestational age (GA) at King's College Hospital and St George's University Hospital, London, United Kingdom between February and September 2018. Expiratory V
T was recorded before extubation, and extubation was considered successful if the infants were not reintubated within 72 hours. Results Fifty-six (29 male) infants with a median (interquartile range) GA of 26 (25-29) weeks were studied. The infants who successfully extubated (N = 36) had a higher GA (27 [25-30] weeks) and V
T (7.2 [4.8-9.5] mL) compared with the GA (25 [24-26] weeks) and V
T (4.3 [4.0-5.5] mL) of the infants who failed extubation (p = 0.002 and p = 0.001, respectively). V
T /kg was not different in infants who successfully extubated compared with the ones who failed extubation (p = 0.643). Following multivariate regression, V
T was associated with extubation success (adjusted p = 0.022) and GA was not (adjusted p = 0.167). A V
T > 4.5 mL predicted successful extubation with 82% sensitivity and 58% specificity (area under the curve = 0.786). Conclusion Successful extubation was associated with higher unadjusted-for-weight V
T s compared with failed extubation, and unadjusted V
T predicted extubation outcome with moderate sensitivity and specificity.
AB - Objectives To compare the adjusted and unadjusted-for-weight tidal volume (V
T) in ventilated prematurely born infants who were successfully extubated compared with the ones who failed extubation and explore the ability of V
T to predict successful extubation. Study Design This is a two-center, prospective, observational, cohort study of ventilated infants born <32 weeks of gestational age (GA) at King's College Hospital and St George's University Hospital, London, United Kingdom between February and September 2018. Expiratory V
T was recorded before extubation, and extubation was considered successful if the infants were not reintubated within 72 hours. Results Fifty-six (29 male) infants with a median (interquartile range) GA of 26 (25-29) weeks were studied. The infants who successfully extubated (N = 36) had a higher GA (27 [25-30] weeks) and V
T (7.2 [4.8-9.5] mL) compared with the GA (25 [24-26] weeks) and V
T (4.3 [4.0-5.5] mL) of the infants who failed extubation (p = 0.002 and p = 0.001, respectively). V
T /kg was not different in infants who successfully extubated compared with the ones who failed extubation (p = 0.643). Following multivariate regression, V
T was associated with extubation success (adjusted p = 0.022) and GA was not (adjusted p = 0.167). A V
T > 4.5 mL predicted successful extubation with 82% sensitivity and 58% specificity (area under the curve = 0.786). Conclusion Successful extubation was associated with higher unadjusted-for-weight V
T s compared with failed extubation, and unadjusted V
T predicted extubation outcome with moderate sensitivity and specificity.
KW - extubation
KW - prematurely born infants
KW - tidal volume
UR - http://www.scopus.com/inward/record.url?scp=85078299019&partnerID=8YFLogxK
U2 - 10.1055/s-0039-1696714
DO - 10.1055/s-0039-1696714
M3 - Article
SN - 0735-1631
VL - 37
SP - 204
EP - 209
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 2
ER -