Extubation Readiness in Preterm Infants: Evaluating the Role of Monitoring Intermittent Hypoxemia

Abstract

Preterm infants with respiratory distress may require mechanical ventilation which is associated with increased pulmonary morbidities. Prompt and successful extubation to noninvasive support is a pressing goal. In this communication, we show original data that increased recurring intermittent hypoxemia (IH, oxygen saturation <80%) may be associated with extubation failure at 72 h in a cohort of neonates <30 weeks gestational age. Current-generation bedside high-resolution pulse oximeters provide saturation profiles that may be of use in identifying extubation readiness and failure. A larger prospective study that utilizes intermittent hypoxemia as an adjunct predictor for extubation readiness is warranted.

Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study

“…Thus, noninvasive oxygenation assessment metrics (RSS and SpO 2 histogram) are useful bedside tools that reflect the severity of respiratory distress. 31,48 Of note, we found that RSS has no significant difference between groups before extubation, yet in the 24 h postextubation, RSS was significantly high in infants who failed extubation. Thus, RSS may be a potential indicator for impeding respiratory failure and prompt timely reintubation.…”

“…Oxygenation status in neonatal lung diseases is difficult to be represented by the mere FiO 2 . Thus, noninvasive oxygenation assessment metrics (RSS and SpO 2 histogram) are useful bedside tools that reflect the severity of respiratory distress 31,48 . Of note, we found that RSS has no significant difference between groups before extubation, yet in the 24 h postextubation, RSS was significantly high in infants who failed extubation.…”