Patterns of reintubation in extremely preterm infants: a longitudinal cohort study

Wissam Shalish, Lara Kanbar, Martin Keszler, Sanjay Chawla, Lajos Kovacs, Smita Rao, Bogdan A Panaitescu, Alyse Laliberte, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
<span title="2018-01-31">2018</span> <i title="Springer Nature"> <a target="_blank" rel="noopener" href="" style="color: black;">Pediatric Research</a> </i> &nbsp;
BACKGROUND: The optimal approach for reporting reintubation rates in extremely preterm infants is unknown. This study aims to longitudinally describe patterns of reintubation in this population over a broad range of observation windows following extubation. METHODS: Timing and reasons for reintubation following a first planned extubation were collected from infants with birth weight ≤ 1,250 g. An algorithm was generated to discriminate between reintubations attributable to respiratory and
more &raquo; ... piratory causes. Frequency and cumulative distribution curves were constructed for each category using 24 h intervals. The ability of observation windows to capture respiratory-related reintubations while limiting non-respiratory reasons was assessed using a receiver operating characteristic curve. RESULTS: Out of 194 infants, 91 (47%) were reintubated during hospitalization; 68% for respiratory and 32% for nonrespiratory reasons. Respiratory-related reintubation rates steadily increased from 0 to 14 days post-extubation before reaching a plateau. In contrast, non-respiratory reintubations were negligible in the first post-extubation week, but became predominant after 14 days. An observation window of 7 days captured 77% of respiratory-related reintubations while only including 14% of non-respiratory cases. CONCLUSION: Reintubation patterns are highly variable and affected by the reasons for reintubation and observation window used. Ideally, reintubation rates should be reported using a cumulative distribution curve over time.
<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="">doi:10.1038/pr.2017.330</a> <a target="_blank" rel="external noopener" href="">pmid:29389921</a> <a target="_blank" rel="external noopener" href="">fatcat:54p76fvmszh53gstcvzlrgxhiu</a> </span>
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