The Impact of Time Interval Between First Extubation and Reintubation on Bronchopulmonary Dysplasia or Death in Very Low Birth Weight Infants

Li, Jing; Zhang, Jing; Hao, Qingfei; Shen, Ziyun; Du, Yanna; Chen, Haoming; Cheng, Xiuyong

doi:10.3389/fped.2022.867767

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…An association between reintubation within 72 hrs of extubation and increased likelihood of moderate-to-severe BPD or death in very low birth weight infants was reported [ 44 ] Here, we found that NHFOV probably reduces the risk of extubation failure or reintubation within 72 hrs in NICU patients when compared to NCPAP or NIPPV. The decreased rate of reintubation probably played a role in the lower occurrence of BPD in neonates receiving NHFOV.…”

Section: Discussionsupporting

confidence: 56%

Noninvasive high-frequency oscillation ventilation as post- extubation respiratory support in neonates: Systematic review and meta-analysis

Prasad,

Saha,

et al. 2024

PLoS ONE

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Introduction Noninvasive High-Frequency Oscillatory Ventilation (NHFOV) is increasingly being adopted to reduce the need for invasive ventilation after extubation. Objectives To evaluate the benefits and harms of NHFOV as post-extubation respiratory support in newborns compared to other non‐invasive respiratory support modes. Material & methods We included randomized controlled trials comparing NHFOV with other non-invasive modes post-extubation in newborns. Data sources were MEDLINE (via Pubmed), Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WHO international clinical trials registry platform and Clinical Trial Registry, forward and backward citation search. Methodological quality of studies was assessed by Cochrane’s Risk of Bias tool 1.0. Results This systematic review included 21 studies and 3294 participants, the majority of whom were preterm. NHFOV compared to nasal continuous positive airway pressure (NCPAP) reduced reintubation within seven days (RR 0.34, 95% CI 0.22 to 0.53) after extubation. It also reduced extubation failure (RR 0.39, 95% CI 0.30 to 0.51) and reintubation within 72 hrs (RR 0.40, 95% CI 0.31 to 0.53), bronchopulmonary dysplasia (RR 0.59, 95% CI 0.37 to 0.94) and pulmonary air leak (RR 0.46, 95% CI 0.27 to 0.79) compared to NCPAP. The rate of reintubation within seven days (RR 0.62, 95% CI 0.18 to 2.14) was similar whereas extubation failure (RR 0.65, 95% CI 0.50 to 0.83) and reintubation (RR 0.68, 95% CI 0.52 to 0.89) within 72 hrs were lower in NHFOV group compared to nasal intermittent positive pressure ventilation. There was no effect on other outcomes. Overall quality of the evidence was low to very low in both comparisons. Conclusions NHFOV may reduce the rate of reintubation and extubation failure post-extubation without increasing complications. Majority of the trials were exclusively done in preterm neonates. Further research with high methodological quality is warranted.

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Section: Discussionsupporting

confidence: 56%

Noninvasive high-frequency oscillation ventilation as post- extubation respiratory support in neonates: Systematic review and meta-analysis

Prasad,

Saha,

et al. 2024

PLoS ONE

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“…Subgroup analysis of two large randomized controlled trials showed that reintubation within 5 and 7 days after extubation is associated with an increased incidence of respiratory diseases including BPD 28 , 29 . But, a single-center retrospective study (n = 244) from Li et al found that reintubation was not an independent risk factor for moderate-to-severe BPD (for reintubations occurring within 72 h after extubation, adjusted OR = 1.714, 95% CI 0.546–5.374; for reintubations occurring within 7 d after extubation, adjusted OR = 1.501, 95% CI 0.482–4.678) 30 . Shalish W et al found that reintubation within observation windows ranging from 24 h to 3 weeks post-extubation was not associated with the increased ORs of BPD among survivors 19 .…”

Section: Discussionmentioning

confidence: 98%

Effect of different courses and durations of invasive mechanical ventilation on respiratory outcomes in very low birth weight infants

Yang,

Gu,

Lin

et al. 2023

Sci Rep

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This multicenter retrospective study was conducted to explore the effects of different courses and durations of invasive mechanical ventilation (MV) on the respiratory outcomes of very low birth weight infants (VLBWI) in China. The population for this study consisted of infants with birth weight less than 1500 g needing at least 1 course of invasive MV and admitted to the neonatal intensive care units affiliated with the Chinese Neonatal Network within 6 h of life from January 1st, 2019 to December 31st, 2020. Univariate and multivariate logistic regression analyses were performed to evaluate associations between invasive MV and respiratory outcomes. Adjusted odds ratios (ORs) were computed with the effects of potential confounders. (1) Among the 3183 VLBWs with a history of at least one course of invasive MV, 3155 (99.1%) met inclusion criteria and were assessed for the primary outcome. Most infants received one course (76.8%) and a shorter duration of invasive MV (62.16% with ventilation for 7 days or less). (2) In terms of the incidence of all bronchopulmonary dysplasia (BPD) (mild, moderate, and severe BPD), there were no significant differences between different invasive MV courses [For 2 courses, adjusted OR = 1.11 (0.88, 1.39); For 3 courses or more, adjusted OR = 1.07 (0.72, 1.60)]. But, with the duration of invasive MV prolonging, the OR of BPD increased [8–21 days, adjusted OR = 1.98 (1.59, 2.45); 22–35 days, adjusted OR = 4.37 (3.17, 6.03); ≥ 36 days, adjusted OR = 18.44 (10.98, 30.99)]. Concerning severe BPD, the OR increased not only with the course of invasive MV but also with the duration of invasive MV [For 2 courses, adjusted OR = 2.17 (1.07, 4.40); For 3 courses or more, adjusted OR = 2.59 (1.02, 6.61). 8–21 days, adjusted OR = 8.42 (3.22, 22.01); 22–35 days, adjusted OR = 27.82 (9.08, 85.22); ≥ 36 days, adjusted OR = 616.45 (195.79, > 999.999)]. (3) When the interaction effect between invasive MV duration and invasive MV course was considered, it was found that there were no interactive effects in BPD and severe BPD. Greater than or equal to three courses would increase the chance of severe BPD, death, and the requirement of home oxygen therapy. Compared with distinct courses of invasive MV, a longer duration of invasive MV (> 7 days) has a greater effect on the risk of BPD, severe BPD, death, and the requirement of home oxygen therapy.

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“…Reintubation within 72 h of initial extubation in very low or extremely low birth weight infants was independently associated with increased risk of BPD/death and death in a retrospective cohort study ( 20 ). This result is consistent with a multicenter observational study ( 21 ) that demonstrated that for preterm infants, reintubation after elective extubation was an independent risk factor for death or moderate to severe BPD, especially reintubation within 48 h of extubation.…”

Section: Discussionmentioning

confidence: 99%

Use of NHFOV vs. NIPPV for the respiratory support of preterm newborns after extubation: A meta-analysis

Mei¹,

et al. 2023

Front. Pediatr.

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ObjectivesThis meta-analysis evaluated and compared the efficacy and safety of noninvasive high-frequency oscillatory ventilation (NHFOV) and nasal intermittent positive-pressure ventilation (NIPPV) for preterm newborns after extubation.MethodsWe searched the PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang and VIP databases from inception to August 28, 2022. Randomized controlled trials (RCTs) that evaluated and compared the efficacy and safety of NHFOV and NIPPV in newborns were included in the review and meta-analysis, which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.ResultsEight studies involving 1,603 patients were included. Compared with NIPPV, NHFOV could reduce the reintubation rates (RR = 0.68, 95% CI 0.53, 0.86, P = 0.002). Subgroup analysis showed that the significant difference was found in reintubation rates within 72 h (RR = 0.48, 95% CI 0.32, 0.73, P = 0.0005). NHFOV also could decrease the duration of non-invasive ventilation (standard mean difference (SMD) = −1.52, 95% CI −2.58, −0.45, P = 0.005). However, all included studies had a high risk of bias, and the overall quality of the evidence of the outcomes was low or very low.ConclusionIn our study, compared with NIPPV, NHFOV seems to reduce the reintubation rates without increasing adverse outcomes. Nevertheless, definite recommendations cannot be made based on the quality of the published evidence.

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The Impact of Time Interval Between First Extubation and Reintubation on Bronchopulmonary Dysplasia or Death in Very Low Birth Weight Infants

Cited by 6 publications

References 21 publications

Noninvasive high-frequency oscillation ventilation as post- extubation respiratory support in neonates: Systematic review and meta-analysis

Noninvasive high-frequency oscillation ventilation as post- extubation respiratory support in neonates: Systematic review and meta-analysis

Effect of different courses and durations of invasive mechanical ventilation on respiratory outcomes in very low birth weight infants

Use of NHFOV vs. NIPPV for the respiratory support of preterm newborns after extubation: A meta-analysis

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