• G Dimitriou, A Greenough, A Endo, S Cherian, and G F Rafferty.
• Children Nationwide Regional Neonatal Intensive Care Unit and Department of Respiratory Medicine, King's College Hospital, London, UK.
• Arch. Dis. Child. Fetal Neonatal Ed. 2002 Jan 1;86(1):F32-5.

ObjectiveTo identify whether the results of assessment of respiratory muscle strength or respiratory load were better predictors of extubation failure in preterm infants than readily available clinical data.PatientsThirty six infants, median gestational age 31 (range 25-36) weeks and postnatal age 3 (1-14) days; 13 were < 30 weeks of gestational age.MethodsRespiratory muscle strength was assessed by measurement of maximum inspiratory pressure generated during airway occlusion, and inspiratory load was assessed by measurement of compliance of the respiratory system.ResultsOverall, seven infants failed extubation-that is, they required reintubation within 48 hours. These infants were older (p < 0.01), had a lower gestational age (p < 0.01), and generated lower maximum inspiratory pressure (p < 0.05) than the rest of the cohort. Similar results were found in the infants < 30 weeks of gestational age. Overall and in those < 30 weeks of gestational age, gestational age and postnatal age had the largest areas under the receiver operator characteristic curves.ConclusionIn very premature infants, low gestational age and older postnatal age are better predictors of extubation failure than assessment of respiratory muscle strength or respiratory load.

19 keywords...

hide…