Document Detail


Predictors of successful extubation of preterm low-birth-weight infants with respiratory distress syndrome.
MedLine Citation:
PMID:  15636658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. DESIGN: Clinical study. SETTING: Neonatal intensive care unit. PATIENTS: Fifty-one infants (birth weight, 1158.6 +/- 150.6 g; gestational age, 29.1 +/- 2.0 wks). INTERVENTIONS: Ventilation and daily ventilatory management. MEASUREMENTS AND MAIN 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. CONCLUSION: 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:
Marta Szymankiewicz; Dharmapuri Vidyasagar; Janusz Gadzinowski
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  6     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-07     Completed Date:  2005-07-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44-9     Citation Subset:  IM    
Affiliation:
Department of Neonatology, University of Medical Sciences, Poznań, Poland.
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MeSH Terms
Descriptor/Qualifier:
Aminophylline / therapeutic use
Bronchodilator Agents / therapeutic use
Dexamethasone / therapeutic use
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Likelihood Functions
Poland
Predictive Value of Tests
Respiration, Artificial / adverse effects,  methods*,  utilization
Respiratory Distress Syndrome, Newborn / physiopathology*,  therapy*
Respiratory Function Tests*
Respiratory Mechanics / physiology
Tidal Volume / drug effects
Treatment Outcome
Ventilator Weaning*
Ventricular Pressure / physiology
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 317-34-0/Aminophylline; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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