Open AccessRisk Factors of Extubation Failure in Intubated Preterm Infants at a Tertiary Care Hospital in Oman
Author(s) -
Hilal Kt Al Mandhari,
Buthina Al Riyami,
Ayesha Khan,
Mika oyama,
Syed Rizvi
Publication year - 2021
Publication title -
sultan qaboos university medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.258
H-Index - 27
eISSN - 2075-0528
pISSN - 2075-051X
DOI - 10.18295/squmj.8.2021.122
Subject(s) - medicine , odds ratio , mechanical ventilation , neonatal intensive care unit , gestational age , apgar score , confidence interval , intensive care , retrospective cohort study , logistic regression , pediatrics , intubation , anesthesia , intensive care medicine , pregnancy , surgery , biology , genetics
Objectives: To determine extubation failure (EF) rate among intubated preterm infants (<37 weeks gestational age [GA]) admitted to a tertiary care neonatal intensive care unit (NICU) in Oman and identify the risk factors associated with EF. Methods: Charts of all intubated preterm infants (<37 weeks GA) from January 2013 to December 2017 were retrospectively reviewed. EF was defined as reintubation within 7 days of planned extubation. Demographics, ventilation parameters, blood gas values and other possible risk factors of EF were collected. Statistical analysis included comparisons between EF and extubation success (ES) groups, and binary logistic regression analysis. Results: A total of 190 preterm infants were intubated during the study period, with 140 eligible for analysis. N=106 were successfully extubated; 34 (24.3%) failed extubation. GA <28 weeks (p=0.029), lower 1-minute APGAR score (p=0.023) and patent ductus arteriosus diagnosis (PDA) (p=0.018) were significantly associated with EF. After the multivariate analysis, only GA <28 weeks predicted EF with adjusted odds ratio (95% confidence interval) of 2.62 (1.17 – 6.15). Conclusions: EF rate in preterm infants admitted at our NICU in Oman, was within international rates. GA <28 weeks was the only predictor of extubation failure identified. Neonatal practitioners need to seriously consider extreme prematurity in extubation process and consider implementing strategies to decrease extubation failure in this group of fragile infants.
Keywords: Premature Infants; Neonate; Airway Extubation; Extubation Failure, Risk Factors.