Failed extubation in the neonatal intensive care unit

Pereira, Kevin D.; Smith, Sarah M.; Henry, Marion C.W.

doi:10.1016/j.ijporl.2007.07.018

Cited by 23 publications

(12 citation statements)

References 15 publications

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“…Our rate of non‐congenital upper airway obstruction of 0.4% was similar to the one of 0.3% reported by Pereira et al6 in ELBW infants. Large endotracheal tube size has been associated with acquired subglottic stenosis 10, 11. Contencin et al (1993)10 reported lower incidence of subglottic stenosis with the use of smaller endotracheal tube (size 2.5 for infants who are <2,000 g).…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with the need for a tracheostomy in extremely low birth weight infants

Viswanathan

Mathew

Worth

et al. 2012

Pediatric Pulmonology

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In an attempt to determine the risk factors associated with the need for a tracheostomy in extremely low birth weight (ELBW) infants, a retrospective, case control study was conducted (each infant with a tracheostomy [case] was matched to two controls). Medical records were reviewed for patients' characteristics, risk factors for tracheostomy and outcome. During the study period (June 1996 to Dec 2010), 934 ELBW infants were admitted to our institution and nine infants had a tracheostomy and were matched to 18 controls. There were no differences in birth weight (BW) and gestation age (GA) between cases and controls (828.1 ± 136.2 g vs. 822.0 ± 140.9 g [P = 0.91] and 26.6 ± 1.8 weeks vs. 26.5 ± 1.6 weeks [P = 0.88], respectively). In comparison to their controls, infants with a tracheostomy had a higher rate of intubation (median 13 [11-15] vs. 3 [2-5], P ≤ 0.001), a higher rate of total intubation attempts (median 18 [13-21] vs. 5.5 [3-7], P = 0.001), and more days of mechanical ventilation prior to their tracheostomy (mean 100.7 ± 27.7 vs. 29.2 ± 19.8 days [P < 0.001]). Also infants with a tracheostomy had a higher rate of non-congenital upper airway obstruction (55% [5/9] vs. 0% [0/18]; P = 0.001), a higher rate of chronic lung disease (100% [9/9] vs. 5% [1/18]; P < 0.001) and a higher mortality (44% [4/9] vs. 0% [0/18]; P = 0.007) than their controls. In conclusion, chronic lung disease, multiple intubations and intubation attempts, duration of mechanical ventilation, and non-congenital upper airway obstruction are risk factors associated with tracheostomies in ELBW infants.

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Section: Discussionmentioning

confidence: 99%

Risk factors associated with the need for a tracheostomy in extremely low birth weight infants

Viswanathan

Mathew

Worth

et al. 2012

Pediatric Pulmonology

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“…[15,16] Pereira et al, retrospectively evaluated all patients who were intubated, irrespective of the duration of intubation. [17] In our study, we included patients who were intubated for at least 48 hours. There is no consensus on when to evaluate the children after extubation.…”

Section: Discussionmentioning

confidence: 99%

“…Pereira et al, did a retrospective analysis on infants, while Smith et a., studied children under five years. [15,17] We included all children, but categorized them into two groups: Group 1-children less than six years, and group 2, children over six years. We hypothesized that there is a difference in the larynx of children under six years and those more than six years.…”

Section: Discussionmentioning

confidence: 99%

“…Pereira et al, in their retrospective study to identify the factors responsible for failed extubation in a Neonatal Intensive Care Unit, reported that the duration of intubation directly affects the incidence of failed extubation and subglottic airway compromise. [17] However, they also noticed that poor pulmonary reserve volume plays an important role in extubation failure. It was observed that some individuals are able to tolerate this excess pressure to a greater extent, while others develop significant injuries even after intubation for a few hours or days.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

“Post intubation Laryngeal injuries in a pediatric intensive care unit of tertiary hospital in India: A Fibreoptic endoscopic study”

Bharti

Syed

Ebenezer

et al. 2016

International Journal of Pediatric Otorhinolaryngology

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“…The spectrum of disease ranges from airway disease associated with congenital heart disease, acquired tracheabronchomalacia requiring long-term ventilation to subglottic stenosis requiring tracheostomy. Fiber-optic bronchoscopy in the ICU is required to assess the airways of these neonates and children to assure correct management [15][16][17][18][19][20]. Performing a bronchoscopy safely in the ICU requires a different skill set as in the ICU there is an increased risk of developing complications and managing them in an unfamiliar environment.…”

Section: Indications For Bronchoscopy In Children In Lmicmentioning

confidence: 99%

The need for bronchoscopic services for children in low and middle-income countries

Goussard

Gie

2016

Expert Review of Respiratory Medicine

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Failed extubation in the neonatal intensive care unit

Cited by 23 publications

References 15 publications

Risk factors associated with the need for a tracheostomy in extremely low birth weight infants

Risk factors associated with the need for a tracheostomy in extremely low birth weight infants

“Post intubation Laryngeal injuries in a pediatric intensive care unit of tertiary hospital in India: A Fibreoptic endoscopic study”

The need for bronchoscopic services for children in low and middle-income countries

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