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Rev Bras Ter Intensiva · Jun 2010
Spontaneous breathing trial evaluation in preterm newborns extubation.
- Lívia Barboza Andrade, Thaís Myrian Aragão Melo, Danielle Ferreira do Nascimento Morais, Marcela Raquel Oliveira Lima, Emídio Cavalcanti Albuquerque, and Paula Honório de Melo Martimiano.
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil.
- Rev Bras Ter Intensiva. 2010 Jun 1;22(2):159-65.
ObjectiveNeonates mechanic ventilation weaning has become a major clinical challenge, and constitutes a large portion of neonatal intensive care units workload. The spontaneous breathing trial (SBT), performed immediately before extubation, can provide useful information on the patient's spontaneous breathing ability. This study aimed to assess the SBT effectiveness for extubation success prediction in mechanically ventilated preterm infants.MethodsAfter Ethics Committee approval, an observational, longitudinal, prospective study was conducted. A sample of 60 preterm infants compliant with the weaning criteria was categorized in two groups: 'SBT' group (n=30), with the patients who underwent 30 minutes spontaneous breathing trial (SBT) with continuous positive pressure airway (CPAP), and the control group (n=30) where the extubation was performed without spontaneous breathing trial. The heart rate (HR), respiratory rate (RR), pulse oxymetry oxygen saturation (SpO2) and the Silverman-Andersen score were recorded before and 10, 20 and 30 minutes after the spontaneous breathing trial. Were also assessed for both groups, and versus extubation success or failure, the weight, gestational age, Apgar score, mean airway pressure, inspired oxygen concentration, and tracheal tube time. The Chi-square test was used for categorical variables and the Mann-Whitney test for non-normal distribution. Extubation success was defined as a 48 hours period with no reintubation requirement.ResultsNo significant differences were identified between the groups for the analyzed variables, except for the mean airway pressure. A significant association was shown between spontaneous breathing trial and successful extubation.ConclusionThe significant association between SBT and extubation success may contribute for prediction of successful weaning in preterm infants.
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