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Predictors of Extubation Success in Extremely Low Birth Weight (ELBW) Infants

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abstract
Objective. To evaluate the value of pre-extubation blood gas parameters, ventilatory settings and nutritional status as predictors of extubation success in extremely low birth weight (ELBW) infants. Methods. Secondary data analysis was performed on a prospective cohort of 161 ELBW infants enrolled in a randomized trial, which compared two nasal continuous positive airway pressure (CPAP) systems for extubation success. Interventions: none. Extubation failure was defined as the need for reintubation within 7 days. Logistic regression models were used to identify clinical predictors of extubation success. Results. Sixty-one infants met criteria for extubation failure and 100 infants met criteria for extubation success. Extubation success was associated with older chronological age (p=0.01), longer duration of intubation (p=0.01) and higher mean extubation weight (p=0.03). The final logistic regression model retained three parameters with significance for extubation success: gestational age, blood pH and total calories on the day of first extubation attempt. Conclusion. Older age, better nutrition and higher blood pH and bicarbonate are associated with extubation success. No other blood gas parameters and no ventilatory settings parameters can reliably predict extubation outcome in ELBW infants. Even the smallest category of infants with birth weight less than 600 g had 50% chance of successful extubation using the suggested extubation guidelines.
subject
predictors
preterm infants
extubation
contributor
Stefanescu, Beatrice (author)
Legault, Claudine (committee chair)
O'Shea, Michael (committee member)
Aschner, Judy (committee member)
Lang, Wei (committee member)
date
2009-11-24T13:03:58Z (accessioned)
2010-06-18T18:56:53Z (accessioned)
2009-11-24T13:03:58Z (available)
2010-06-18T18:56:53Z (available)
2009-11-24T13:03:58Z (issued)
degree
Clinical Epidemiology & Health Services (discipline)
identifier
http://hdl.handle.net/10339/14655 (uri)
language
en_US (iso)
publisher
Wake Forest University
rights
Release the entire work for access only to the Wake Forest University system for one year from the date below. After one year, release the entire work for access worldwide. (accessRights)
title
Predictors of Extubation Success in Extremely Low Birth Weight (ELBW) Infants
type
Thesis

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