Decision to extubate extremely preterm infants: art, science or gamble?

In the modern era of neonatology, mechanical ventilation has been restricted to a smaller and more immature population of extremely preterm infants. Given the adverse outcomes associated with mechanical ventilation, every effort is made to extubate these infants as early as possible. However, the sc...

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Bibliographic Details
Published inArchives of disease in childhood. Fetal and neonatal edition Vol. 107; no. 1; pp. 105 - 112
Main Authors Shalish, Wissam, Keszler, Martin, Davis, Peter G, Sant’Anna, Guilherme M
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.01.2022
BMJ Publishing Group LTD
Subjects
Airway Extubation - adverse effects
Airway management
Babies
Clinical Decision-Making
Edema
Evidence-Based Medicine
Extubation
Humans
Infant, Extremely Premature
Infant, Newborn
Infants
Infections
Lung diseases
Morbidity
Mortality
neonatology
Newborn babies
Ostomy
Pediatrics
physiology
Premature babies
Premature birth
Review
Tracheotomy
Ventilation
Ventilator Weaning
Ventilators
physiology
neonatology
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Summary:In the modern era of neonatology, mechanical ventilation has been restricted to a smaller and more immature population of extremely preterm infants. Given the adverse outcomes associated with mechanical ventilation, every effort is made to extubate these infants as early as possible. However, the scientific basis for determining extubation readiness remains imprecise and primarily guided by clinical judgement, which is highly variable and subjective. In the absence of accurate tools to assess extubation readiness, many infants fail their extubation attempt and require reintubation, which also increases complications. Recent advances in the field have led to unravelling some of the complexities surrounding extubation in this population. This review aims to synthesise the available knowledge and provide a more evidence-based approach towards the reporting of extubation outcomes and assessment of extubation readiness in extremely preterm infants.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:1359-2998
1468-2052
DOI:10.1136/archdischild-2020-321282