ABSTRACT 463

Abstract

Background and aims: Paediatric extubation failure, defined as need for re-intubation within 24–72 hours is multifactorial and factors helpful for predicting extubation failure in adults generally are not useful. Aims: We undertook the study with the aim to see factors associated with this and thereby to facilitate prediction of extubation failure. Methods: After ethics committee approval, all consecutive newborns, infants and children <12 years of age, admitted to PICU and NICU remained on ventilator for >12 hours, were included and prospectively followed up till they were extubated. Cases of upper airway obstruction, neuromuscular disorders, anatomic malformations, accidental extubation, tracheostomy or death before extubation were excluded. Results: Data collected for 92 ventilated patients, 64 were extubated following application of 30 minutes spontaneous breathing trial (SBT) using PEEP and pressure support delivered through the ventilator. 16 (25%) patients failed extubation. Extubation following SBT has sensitivity 72%, and PPV 75% over extubation following clinical decision (p=0.4237). 7 patients failed SBT and subsequently failed extubation. Extubation following successful SBT has sensitivity 87%, specificity 100%, PPV 100%, positive likelihood ratio of 49 over extubation following failed SBT (p=0.0001) in predicting successful extubation.Table: No title available.Conclusions: 30 minutes SBT is a simple and reliable predictor of extubation success in paediatric and neonatal intensive care unit.