title: Risk factors of extubation failure in extremely low birth weight infants: a five year retrospective analysis.
abstract: Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.
authors.affiliation: Department of Pediatrics, China Medical College Hospital, Kuang Tien General Hospital, Taichung, Taiwan.
authors.forename: Chao-Yi
authors.initials: CY
authors.lastname: Lee
authors.forename: Bai-Horng
authors.initials: BH
authors.lastname: Su
authors.forename: Tsung-Wen
authors.initials: TW
authors.lastname: Lin
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Lin
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.forename: Nai-Phon
authors.initials: NP
authors.lastname: Wang
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors