title: Predictors of successful extubation of preterm low-birth-weight infants with respiratory distress syndrome.
abstract: OBJECTIVE
  The aim of the study was to measure pulmonary mechanics in infants with respiratory distress syndrome before extubation and to correlate pulmonary function values with successful extubation.
  
  
  METHODS
  Clinical study.
  
  
  METHODS
  Neonatal intensive care unit.
  
  
  METHODS
  Fifty-one infants (birth weight, 1158.6 +/- 150.6 g; gestational age, 29.1 +/- 2.0 wks).
  
  
  METHODS
  Ventilation and daily ventilatory management.
  
  
  RESULTS
  Of the 51 infants studied, 35 (60.8%) were successfully extubated, whereas 16 (39.2%) required reintubation and mechanical ventilation within 72 hrs after extubation. All patients met the clinical and biochemical criteria for extubation. Variables of artificial ventilation before extubation were minimal in all the studied cases (Fio(2) </=0.4, inspiratory pressure </=20 cm H(2)O, ventilatory rate, </=10/min). Pulmonary mechanics were measured before extubation using a noninvasive, mobile VenTrak measuring station.
  
  
  RESULTS
  Significant differences in pulmonary function values between the groups were found. Lower resistance of airways and work of breathing and higher dynamic compliance, tidal volume, and minute ventilation before extubation were associated with successful extubation.
  
  
  CONCLUSIONS
  On the average, tidal volume values of >6 mL/kg, minute ventilation of >309 mL/kg/min, work of breathing of <0.172 J/L, dynamic compliance of >/=1 mL/cm H(2)O/kg, and resistance of airways of </=176 cm H(2)O/L/sec predicted successful extubation. We recommend measurement of pulmonary function as an assessment tool in determining readiness for extubation.
authors.affiliation: Department of Neonatology, University of Medical Sciences, Poznań, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Szymankiewicz
authors.forename: Dharmapuri
authors.initials: D
authors.lastname: Vidyasagar
authors.forename: Janusz
authors.initials: J
authors.lastname: Gadzinowski
mesh_terms: D000628:Aminophylline / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D016013:Likelihood Functions; D011044:Poland; D011237:Predictive Value of Tests; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology* / Q000628:therapy*; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics / Q000502:physiology; D013990:Tidal Volume / Q000187:drug effects; D016896:Treatment Outcome; D015300:Ventilator Weaning; D017725:Ventricular Pressure / Q000502:physiology
chemical_list: D001993:Bronchodilator Agents; D000628:Aminophylline; D003907:Dexamethasone