Predictors of extubation outcomes among extremely and very preterm infants: a retrospective cohort study

Abstract

ObjectiveTo explore the clinical or sociodemographic predictors for both successful and failed extubation among Chinese extremely and very preterm infants MethodsA retrospective cohort study was carried out among extremely and very preterm infants born at less than 32 weeks of gestational age (GA). ResultsCompared with the infants who experienced extubation failure, the successful infants had higher birth weight (OR 0.997; CI 0.996–0.998), higher GA (OR 0.582; 95% CI 0.499–0.678), a caesarean section delivery (OR 0.598; 95% CI 0.380–0.939), a higher five-minute Apgar score (OR 0.501; 95% CI 0.257–0.977), and a higher pH prior to extubation (OR 0.008; 95% CI 0.001–0.058). Failed extubation was associated with older mothers (OR 1.055; 95% CI 1.013–1.099), infants intubated in the delivery room (OR 2.820; 95% CI 1.742–4.563), a higher fraction of inspired oxygen (FiO2) prior to extubation (OR 5.246; 95% CI 2.540–10.835), higher partial pressure of carbon dioxide (PCO2) prior to extubation (OR 7.820; 95% CI 3.725–16.420), and higher amounts of lactic acid (OR 1.478;95% CI 1.063–2.056). ConclusionsHigher GA, higher pre-extubation pH, lower pre-extubation FiO2 and PCO, and lower age at extubation are significant predictors of successful extubation among extremely and very preterm infants.