Presented at the Neonatal Society Spring Meeting 2019.
Authors: Aishin Lok, C Hudson, C Vasudevan, S Seal. Introduced by Dr Ela Chakkarapani
Institution(s)
Bradford Neonatal Unit
Introduction
Prolonged mechanical ventilation in the extremely preterm infant is associated with many morbidities and mortality. There are no measurements with satisfactory levels of sensitivity and specificity to predict the optimal moment for extubation. We aim to explore extubation practices in the extremely preterm /extremely low birth weight (ELBW) infants in 4 tertiary neonatal units across Yorkshire Neonatal Network and to assess
Methods
A retrospective cohort study of extremely preterm infants (<27 weeks gestational age) or ELBW infants (birth weight <1000g) requiring mechanical ventilation at birth in 2016. Successful extubation is defined as not requiring reintubation for 72 hours
Results
195 infant’s data were analysed.
Use of morphine pre-extubation, incomplete antenatal steroids and haemoglobin levels of less than 12 were positively associated with extubation failure. Infants who failed extubation had a higher mortality rate before discharge, retinopathy of prematurity, longer duration of respiratory support and hospitalisation.
Conclusions
Early extubation is feasible in the extremely preterm infants if pre-extubation conditions are optimised. Results of this study
References: Acknowledgement: Leeds Neonatal Unit, Hull Neonatal Unit, Jessops Neonatal Unit.
Senior author supporting presentation on day of meeting: Dr C Vasudevan
Corresponding author e-mail address: aishin@doctors.org.uk