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Role of spontaneous breathing trial in predicting successful extubation in premature infants.
MedLine Citation:
PMID:  22811341     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The ability of clinicians to predict successful extubation in mechanically ventilated premature neonates is limited. Identifying objective criteria for predicting successful extubation may reduce the incidence of failed extubation and the duration of mechanical ventilation. OBJECTIVE: To evaluate the validity of objective measures of lung function and spontaneous breathing trial (SBT) in predicting successful extubation among premature neonates with attempted extubations within the first 3 weeks of life. METHODS: Respiratory compliance (Crs) along with SBT was performed prior to elective extubations within 3 weeks of age in premature infants ≤32 weeks. Extubation was considered successful if patients remained extubated for >72 hr. Ventilator settings including mean airway pressure (MAP), set rate, and fraction of inspired oxygen (FiO(2) ) 24 hr after re-intubation were compared with pre-extubation settings, in patients requiring re-intubation. RESULTS: Thirty-nine of 49 infants (80%) were successfully extubated. Of 41 babies who passed SBT, only 5 infants failed extubation. SBT had 92% sensitivity, 50% specificity, 88% positive predictive, and 63% negative predictive value for successful extubation. Crs was comparable between infants who were successfully extubated and those who were not. CONCLUSIONS: A SBT prior to extubation may be a practical objective adjunct in predicting successful extubation in ventilated premature infants. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc.
Authors:
Sanjay Chawla; Girija Natarajan; Matthew Gelmini; S Nadya J Kazzi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-18
Journal Detail:
Title:  Pediatric pulmonology     Volume:  -     ISSN:  1099-0496     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Division of Neonatal Perinatal Medicine, Hutzel Women's Hospital, Wayne State University, Detroit, Michigan. schawla@dmc.org.
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