Use of preestablished criteria for deciding on extubation in the very low birthweight newborn. Preliminary analysis of a randomized study.
The duration of mechanical ventilation (MV) in very low birthweight infants can sometimes be very prolonged, even in the absence of any respiratory disease. To avoid this, we have developed a double-blind study protocol of the concomitant use of caffeine and doxapram or caffeine and placebo as an aid to early weaning from MV. This protocol necessitated the definition of very precise ventilatory criteria for extubation. Even before the double-blind code has been broken, we can note that the duration of ventilation was very significantly reduced (p < 0.001) from 27.5 days (median; range 1-99) in infants of the retrospective study group to 4 days (median: range 1-34) in the prospective study group (extubation according to strict criteria). This reduction in duration of MV cannot be explained by a difference in the severity of the initial pathology, or by the treatment of some of the infants with doxapram (the difference would not be so marked), but, probably, to the definition of strict criteria concerning extubation.
Huon
C
C
Service de Médecine Néonatale, Maternité Port-Royal, Paris, France.
Moriette
G
G
Mussat
P
P
Parat
S
S
Relier
J P
JP
D002110:Caffeine / Q000627:therapeutic use; D004311:Double-Blind Method; D004315:Doxapram / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors
D002110:Caffeine; D004315:Doxapram