Success rate and neonatal morbidities associated with early extubation in extremely low birth weight infants

doi:10.4103/0256-4947.87092

Ann Saudi Med. 2011 Nov-Dec; 31(6): 577–580.

PMCID: PMC3221127

Success rate and neonatal morbidities associated with early extubation in extremely low birth weight infants

Khaled Al Faleh,^a Kenneth Liew,^b Jasim Anabrees,^c Kayal Thevathasan,^b and Bosco Paes^b

From the ^aDivision of Neonatology, Department of Pediatrics, King Saud University, College of Medicine, Riyadh, Saudi Arabia

^bDivision of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

^cNeonatal Intensive Care Unit, Arryan Hospital, Riyadh, Saudi Arabia

Correspondence: Khaled Al Faleh. Division of Neonatology, Department of Pediatrics, King Saud University, King Khalid University Hospital and College of Medicine, PO Box 7805, Riyadh 11472, Saudi Arabia. T: +966556031222, F: +96614671709A. Email: kfaleh/at/ksu.edu.sa

Accepted January 2011.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND AND OBJECTIVES:

Mechanical ventilation improves survival of preterm infants with respiratory failure. The aim of this study was to determine the success rate and short-term neonatal morbidities of early extubation in extremely low birth weight (ELBW) infants in a tertiary care neonatal intensive care unit (NICU).

DESIGN AND SETTING:

Retrospective cohort study of ELBW infants admitted to a tertiary. neonatal intensive care referral unit from January 1^st to December 31^st, 2005.

PATIENTS AND METHODS:

The primary outcome was the success rate of early extubation in ELBW infants who were intubated at delivery, extubated in the first 48 hours of life, and did not require reintubation within 72 hours following extubation.

RESULTS:

Thirty of the 95 eligible infants were extubated early; of these 30 infants, 24 (80%) had a successful extubation. Infants extubated early had a higher mean birth weight (855 vs 745 g; P<.0001) and gestational age (27.3 vs 25.6 weeks; P<.0001). ELBW infants who were extubated early had lower rates of death (relative risk [RR], 0.05; 95% CI, (0.0, 0.79); P=.003), intraventricular hemorrhage (IVH) (RR, 0.23; 95% CI, 0.08, 0.70; P=.008), and patent ductus arteriosus (PDA) (RR, 0.76; 95% CI, 0.60, 0.98; P=.03) compared with those who remained ventilated beyond the first 48 hours of life.

CONCLUSION:

The rate of successful early extubation in our unit exceeded the sole previously reported rate. Successful early extubation was associated with lower rates of death, IVH, and PDA in ELBW infants.

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