PS-379 The Optimal Predictors Of Readiness For Extubation In Low Birth Weight Infants

Abstract

Background and aims Reintubation, following an unsuccessful extubation from mechanical ventilation is traumatic to the infant and the family. However 20–40% of infants fail extubation and reintubation. The aim of the study was to determine the optimal predictors of readiness for extubation in low birth weight infants during endotracheal tube-continuous positive airway pressure (ETT-CPAP) for three minutes. Methods A prospective cohort study was undertaken in 51 mechanically ventilated infants who were considered to be ready for extubation. The infants were changed to ETT-CPAP for a 3-minute spontaneous breathing test (SBT) before extubated. Infants were divided into two groups based upon whether they failed or passed the extubation attempt. Extubation failure was defined as reintubation within 72 h of extubation. Results Forty-five of 51 infants (88%) were successfully extubated. Out of the 51 infants only one infant failed the SBT. The three predictors of extubation success that included the SBT, ratio of minute ventilation during ETT-CPAP to mechanical ventilation and ratio of respiratory frequency during ETT-CPAP to mechanical ventilation were not significantly different. Using synchronised nasal intermittent positive pressure ventilation after extubation in the failed extubation group was significantly higher than the successful extubation group (66.7% vs 15.7%, p = 0.02). Conclusion The SBT and minute ventilation ratio in low birth weight infants were not optimal predictors of readiness for extubation. However, a further prospective study in this field with a larger number of subjects and a proper indication for extubation should be considered.