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Pediatr Crit Care Me · Jan 2005
Comparative StudyPredictors of successful extubation of preterm low-birth-weight infants with respiratory distress syndrome.
- Marta Szymankiewicz, Dharmapuri Vidyasagar, and Janusz Gadzinowski.
- Department of Neonatology, University of Medical Sciences, Poznań, Poland.
- Pediatr Crit Care Me. 2005 Jan 1;6(1):44-9.
ObjectiveThe 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.DesignClinical study.SettingNeonatal intensive care unit.PatientsFifty-one infants (birth weight, 1158.6 +/- 150.6 g; gestational age, 29.1 +/- 2.0 wks).InterventionsVentilation and daily ventilatory management.Measurements And Main ResultsOf 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.ResultsSignificant 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.ConclusionOn 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.
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