title: Automated analysis of respiratory behavior in extremely preterm infants and extubation readiness.
abstract: BACKGROUND
  Rates of extubation failure of extremely preterm infants remain high. Analysis of breathing patterns variability during spontaneous breathing under endotracheal tube continuous positive airway pressure (ETT-CPAP) is a potential tool to predict extubation readiness.
  
  
  OBJECTIVE
  To investigate if automated analysis of respiratory signals would reveal differences in respiratory behavior between infants that were successfully extubated or not.
  
  
  METHODS
  Respiratory Inductive Plethysmography (RIP) signals were recorded during ETT-CPAP just prior to extubation. Signals were digitized, and analyzed using an Automated Unsupervised Respiratory Event Analysis (AUREA). Extubation failure was defined as reintubation within 72 hr. Statistical differences between infants who were successfully extubated or failed were calculated.
  
  
  RESULTS
  A total of 56 infants were enrolled and one was excluded due to instability during the ETT-CPAP; 11 out of 55 infants studied failed extubation (20%). No differences in demographics were observed between the success and failure groups. Significant differences on the variability of some respiratory parameters or 'metrics' estimated by AUREA were observed between the 2 groups. Indeed, a simple classification using the variability of two metrics of respiratory behavior predicted extubation failure with high accuracy.
  
  
  CONCLUSIONS
  Automated analysis of respiratory behavior during a short ETT-CPAP period may help in the prediction of extubation readiness in extremely preterm infants.
authors.affiliation: Department of Biomedical Engineering, McGill University, Montreal, Canada.
authors.forename: C A
authors.initials: CA
authors.lastname: Robles-Rubio
authors.forename: J
authors.initials: J
authors.lastname: Kaczmarek
authors.forename: S
authors.initials: S
authors.lastname: Chawla
authors.forename: L
authors.initials: L
authors.lastname: Kovacs
authors.forename: K A
authors.initials: KA
authors.lastname: Brown
authors.forename: R E
authors.initials: RE
authors.lastname: Kearney
authors.forename: G M
authors.initials: GM
authors.lastname: Sant Anna
mesh_terms: D000465:Algorithms; D045422:Continuous Positive Airway Pressure / Q000379:methods; D001330:Electronic Data Processing / Q000379:methods*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008297:Male; D010991:Plethysmography / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D015300:Ventilator Weaning / Q000379:methods*
keywords: extreme preterm infants; extubation failure; extubation readiness; respiratory behavior; ventilation weaning