1356 Extubation Failure in Very Low Birth Weight Preterm: Incidence and Risk Factors

Abstract

A high rate (10-50%) of preterm infant, intubated shortly after birth need reintubation with associated complications (longer mechanical ventilation, hospital stay, higher mortality rate). Objectives: identify incidence and risk factors associated with failure of extubation in very low birth weight (VLBW). Population and Methods: Retrospective study including 118 preterm infants with VLBW ≤1500 grs requiring mechanical ventilation (MV) within the first 24 hours of life. Extubation failure was defined as the need for reintubation within 7 days after the first Extubation attempt. Results: 7 patients died before the first Extubation attempt. Of the remaining 111 patients, 19 (17%) failed extubation. Global mortality rate was 18,6% and was higher in the failure group than in the Successful group (47% vs 13%, p: 0,02). Comparing the two groups (Failure vs Success) with a stepwise linear regression, there was a statistically significant difference regarding birth weight (950 ± 250 grs vs 1370 ± 220 grs, ORaj: 4,5), gestational age (27 ± 1 weeks vs 29,5 ± 3 weeks, ORaj:6,1) and severe respiratory distress syndrome (53% vs 22%, ORaj: 3,1). Failure of the first Extubation attempt was associated with longer duration of mechanical ventilation and length of hospital stay (p:0,01). Conclusion: Incidence of Extubation failure in our very low birth weight preterm population (17%) is similar to the litteraturre reported rate. Main risk factors include: prematurity, very low birth weight and severe respiratory distress at admission. Implementation of Extubation strategies based on this risk factors can reduce the amount of extubation failure.