Prediction of extubation failure in preterm infants.
OBJECTIVE
To identify whether the results of assessment of respiratory muscle strength or respiratory load were better predictors of extubation failure in preterm infants than readily available clinical data.


METHODS
Thirty six infants, median gestational age 31 (range 25-36) weeks and postnatal age 3 (1-14) days; 13 were < 30 weeks of gestational age.


METHODS
Respiratory muscle strength was assessed by measurement of maximum inspiratory pressure generated during airway occlusion, and inspiratory load was assessed by measurement of compliance of the respiratory system.


RESULTS
Overall, seven infants failed extubation-that is, they required reintubation within 48 hours. These infants were older (p < 0.01), had a lower gestational age (p < 0.01), and generated lower maximum inspiratory pressure (p < 0.05) than the rest of the cohort. Similar results were found in the infants < 30 weeks of gestational age. Overall and in those < 30 weeks of gestational age, gestational age and postnatal age had the largest areas under the receiver operator characteristic curves.


CONCLUSIONS
In very premature infants, low gestational age and older postnatal age are better predictors of extubation failure than assessment of respiratory muscle strength or respiratory load.
Dimitriou
G
G
Children Nationwide Regional Neonatal Intensive Care Unit and Department of Respiratory Medicine, King's College Hospital, London, UK.
Greenough
A
A
Endo
A
A
Cherian
S
S
Rafferty
G F
GF
D000367:Age Factors; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000628:therapy*; D007442:Intubation, Intratracheal; D008170:Lung Compliance; D012372:ROC Curve; D012132:Respiratory Muscles / Q000503:physiopathology; D012307:Risk Factors; D017211:Treatment Failure; D015300:Ventilator Weaning