Avaliação do teste de respiração espontânea na extubação de neonatos pré-termo

Andrade, Lívia Barboza de; Melo, Thaís Myrian Aragão; Morais, Danielle Ferreira do Nascimento; Lima, Marcela Raquel Oliveira; Albuquerque, Emídio Cavalcanti de; Martimiano, Paula Honório de Melo

doi:10.1590/s0103-507x2010000200010

Cited by 13 publications

(7 citation statements)

References 30 publications

(45 reference statements)

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“…For older infants with GA greater than 33 weeks there was also a reduction in extubation failure, but this result was not statistically significant (6.7% in Group 1 to 3.3% in Group 2). Most research of ERT protocols are in younger, smaller infants [10, 19, 20, 34, 35] or older children [11, 36, 37] and we could not find studies describing ERT protocols in older infants. Future research in extubation and weaning practices should target this subgroup of neonates.…”

Section: Discussionmentioning

confidence: 94%

“…Hermeto et al [10] found a reduction in extubation failure from 40% (prior to SBT implementation) to 26% (1 year) and 20% (2 years) post-implementation. Andrade et al [20] showed a difference of 33.3% with an SBT protocol compared with 63.3% without an SBT protocol. Although extubation failure was reduced, the DOI remained the same (median 3 days).…”

Section: Discussionmentioning

confidence: 99%

“…The unique 10-min two-stage SBT used in this study was not only guided by evidence [21, 35, 36] but also equally by clinical expertise. Several different iterations of ERT protocols [10–12, 19, 20, 34–37] have been investigated in the past, each showing success at reducing extubation failure rates and (or) duration of mechanical ventilation. It is likely that both our ERT protocol and the consistent and systematic use is what contributed to its success [28, 38].…”

Section: Discussionmentioning

confidence: 99%

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Effects of an extubation readiness test protocol at a tertiary care fully outborn neonatal intensive care unit

Mandhari¹,

Finelli²,

Chen³

et al. 2019

Can J Respir Ther

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Background and objectivesExtubation readiness testing (ERT) in the Neonatal Intensive Care Unit (NICU) is highly variable and lacking standardized criteria. To address this gap, an evidence-based, inter-professionally developed ERT protocol was implemented to assess effectiveness on extubation failure within 72 h and on duration of intubation (DOI).MethodsA longitudinal retrospective chart review in a level III, fully outborn NICU, of intubated infants admitted 1-year prior (Group 1), and 1 year after implementation (Group 2). Patients were extubated if they passed a 2-stage ERT protocol (3 min continuous positive airway pressure (CPAP) followed by 7 min CPAP + pressure support). Descriptive, comparative statistics, and univariate and multiple logistic regression were completed on all patients and a ≤32 6/7 weeks subgroup (intubated at day-of-life 1); p < 0.05 is considered significant.ResultsAll patients (n = 589 (n = 294 Group 1, n = 295 Group 2)) were included (preterm, intubated day of life one subgroup: n = 42 Group 1, n = 38 Group 2). For all patients, extubation failure decreased significantly from 9.9% to 4.1% (p = 0.006); Group 1 patients were 2.42 times more likely to experience extubation failure compared with Group 2. Extubation failure in the preterm subgroup decreased from 21.7% to 2.6% (p = 0.01); Group 1 patients were 10.71 times more likely to experience extubation failure. Median DOI was similar in both groups for all patients and in the preterm subgroup.ConclusionsA unique two-stage ERT protocol was effective at reducing extubation failure rate, without increasing DOI, largely in preterm infants. The evidence-based, interprofessionally developed ERT protocol and its integration into the NICU culture largely contributed to its success.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of an extubation readiness test protocol at a tertiary care fully outborn neonatal intensive care unit

Mandhari¹,

Finelli²,

Chen³

et al. 2019

Can J Respir Ther

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“…This study analyzed risk factors that behave as predictors of extubation failure and reintubation, as determining the ideal time to perform extubation in newborn infants is quite difficult and a subject of controversy, where clinical judgment is required to balance the benefits of extubation with the damaging effects of reintubation. ( 2 , 6 )…”

Section: Discussionmentioning

confidence: 99%

“…Based on the damage associated with the inappropriate duration of MV in newborn infants, there is a clear need to establish objective criteria for extubation, which would help to avoid undesirable outcomes, such as extubation failure ( 3 , 5 , 6 ) and reintubation, which bear direct associations with morbidity and mortality. ( 7 , 8 )…”

Section: Introductionmentioning

confidence: 99%

Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

Costa¹,

Schettino²,

Ferreira³

2014

Revista Brasileira De Terapia Intensiva

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ObjectiveTo identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes.MethodsProspective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours.ResultsBased on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation.ConclusionLow five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.

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Role of physical therapists in the weaning and extubation procedures of pediatric and neonatal intensive care units: a survey

Bacci

Pereira

Chagas

et al. 2019

Brazilian Journal of Physical Therapy

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Avaliação do teste de respiração espontânea na extubação de neonatos pré-termo

Cited by 13 publications

References 30 publications

Effects of an extubation readiness test protocol at a tertiary care fully outborn neonatal intensive care unit

Effects of an extubation readiness test protocol at a tertiary care fully outborn neonatal intensive care unit

Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

Role of physical therapists in the weaning and extubation procedures of pediatric and neonatal intensive care units: a survey

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