Difficult extubation in low birthweight infants

Archives of Disease in Childhood. Fetal and Neonatal Edition
Anne Greenough, M Prendergast


Randomised trials have demonstrated that ventilation techniques which support every spontaneous breath are the most efficacious weaning modes. Nasal continuous positive airway pressure after extubation reduces the likelihood of incidents leading to the need for reintubation in very low birthweight infants; further work is needed to determine if there are advantages of particular delivery techniques. Both methylxanthines and dexamethasone facilitate weaning and extubation; the efficacy of low-dose dexamethasone merits further investigation. Assessments of the efficacy of respiratory efforts and hence the balance of respiratory drive, muscle performance and respiratory load appear to best predict weaning and extubation success. Essential to the success of weaning and extubation are dedicated staff, whether this will be assisted by computerised decision-making tools requires testing. The above approaches are not mutually exclusive and those indicated by this review as appropriately evidence based should be considered by practitioners for current use to reduce difficult/unsuccessful extubation.


Mar 10, 2009·European Journal of Pediatrics·Zainab KassimGerrard F Rafferty
Sep 29, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Camilla GizziRocco Agostino
May 15, 2012·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·UNKNOWN Grupo Respiratorio y Surfactante de la Sociedad Española de Neonatología
Aug 2, 2015·European Journal of Pediatrics·Yue YinDavid A Todd
Dec 30, 2017·Journal of Neonatal-perinatal Medicine·Corrie J Alonzo, Karen D Fairchild
Jul 19, 2008·Journal of Applied Physiology·Nathalie SamsonJean-Paul Praud

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