Respiratory support adequacy for very low birth weight infants post extubation

الملخص EN

Objective: Study of risk factors related to extubation trial failure for very low birth infants.

Results: The study analyzed antenatal risk factors, ventilation parameters, blood gas results prior and two hours post extubation trial, phosphorus level at 2nd week of life, 446patients <32 weeks GA, or < 1500 g birth weight were included.

Extubation trial for each GA group is enlighted by Antenatal history for best results.

For GA (21+4-26+6) weeks, extubation failure is associated with male gender, post extubation FIO2 level >0.30, high PCO2 level above 55 mm.hg post extubation, ground glass appearance on chest XR at extubation trial, large PDA, low and advanced grade intraventricular hemorrhage.

While extubation success is associated with deferring extubation until FIO2 requirement level is low to the level of (0.25), positive end expiratory pressure (PEEP) level range of (6-7) cm water.

For GA groups (27-29+6), extubation failure is associated with post extubation FIO2 level >0.30 low PH level (6.9-7.24) post extubation, advanced intraventricular hemorrhage IVH grade (3 and 4), while extubation success is associated with deferring extubation until FIO2 requirement is low to the level of (0.21), and post extubation positive end expiratory pressure (PEEP) level range (6-7) cm.water.

For GA group (30- 32w), extubation failure is associated with post extubation FIO2 level >0.30, low PH level (6.97.24-) post extubation, low PO2 (20-40) mm.Hg post extubation, large PDA, while success is associated with deferring extubation until FIO2 requirement is low to the level of (0.25 and inspiratory time >0.38 seconds before extubation).

For safe extubation, number of surfactant treatment doses are guided by GA group.

Low phosphorus level is associated with extubation failure.