ABSTRACT ( ≤ 250 words)
Background and Objectives: Extubation failure in preterm
infants is associated with increased risk of mortality and morbidities.
There is limited evidence to suggest if the increased morbidities are
due to inherent differences among infants who fail or succeed; or
whether these are due to a true respiratory setback among those who fail
extubation. The aim of this study was to evaluate the respiratory status
of infants who fail extubation and to assess the time taken for these
infants to achieve pre-extubation respiratory status.
Methods: This was a retrospective study of infants with birth
weight ≤1,250 g who were born between January 2009 and December 2016.
Infants were eligible if they failed first elective extubation.
Extubation failure was defined as need for re-intubation within 5 days
of extubation. Ventilator settings, blood gas parameters, respiratory
severity score and ventilation index were used to assess respiratory
status of infants.
Results: Of 384 infants, 76% were successful and 24% failed
extubation. Among those who failed extubation 91%, 77% and 56%
infants remained intubated at 24 hours, 72 hours and 7 days,
respectively. Respiratory status was worse at 24 hours and 72 hours
after re-intubation when compared to pre-extubation levels. The median
times for respiratory severity score and ventilation index to reach
pre-extubation levels were 4 days and 7 days respectively.