Prediction of infant extubation outcomes using the tension-time index

Archives of Disease in Childhood. Fetal and Neonatal Edition
Prashanth BhatA Greenough

Abstract

The tension-time index of the diaphragm (TTdi) is a composite assessment of the load on and the capacity of the diaphragm. TTmus is a non-invasive tension-time index of the respiratory muscles. Our aim was to determine whether TTdi or TTmus predicted extubation outcome and performed better than respiratory muscle strength (Pimax, Pdimax), respiratory drive (P0.1) and work of breathing (transdiaphragmatic pressure-time product (PTPdi)) or routinely available clinical data. Prospective study. Tertiary neonatal intensive care unit. Sixty infants, median gestation age 35 (range 23-42) weeks and postnatal age of 55 (range 1-115) days. Airway occlusions were performed to measure Pimax, Pdimax and P0.1. TTdi and PTPdi were derived from measurements of transdiaphragmatic pressure. TTmus was derived from airway pressure measurements. Measurements were made within 6 h of extubation. Extubation failure defined as reintubation within 48 h of extubation. Twelve infants failed extubation. The infants who failed extubation were significantly more immature (medians 25 vs 37 weeks) and of greater postnatal age (23 vs 5 days) and had higher TTdi (0.15 vs 0.04) and TTmus (0.17 vs 0.08). TTdi and TTmus were only significantly better predictors tha...Continue Reading

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Citations

Mar 10, 2018·Archives of Disease in Childhood. Fetal and Neonatal Edition·Wissam ShalishGuilherme Mendes Sant'Anna
Jul 1, 2020·Journal of Perinatal Medicine·Katie A HuntAnne Greenough
Feb 26, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Wissam ShalishGuilherme M Sant'Anna
Apr 21, 2021·Pediatric Research·Theodore DassiosGabriel Dimitriou

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