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Tidal volumes and outcome of extubation in mechanically ventilated premature infants: Extubation tidal volumes in premature infants

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Theodore Dassios, Emma Williams, Hemant Ambulkar, Sandeep Shetty, Ann Hickey, Anne Greenough

Original languageEnglish
Pages (from-to)204-209
Number of pages6
JournalAmerican Journal of Perinatology
Issue number2
Early online date6 Sep 2019
Accepted/In press19 Jul 2019
E-pub ahead of print6 Sep 2019
Published1 Jan 2020


King's Authors


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.

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