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Predictors of extubation failure in newborns: a systematic review and meta-analysis
Extubation failure (EF) is a significant concern in mechanically ventilated newborns, and predicting its occurrence is an ongoing area of research. To investigate the predictors of EF in newborns undergoing planned extubation, we conducted a systematic review and meta-analysis. A systematic literatu...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546653/ https://www.ncbi.nlm.nih.gov/pubmed/37784184 http://dx.doi.org/10.1186/s13052-023-01538-0 |
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author | Fu, Maoling Hu, Zhenjing Yu, Genzhen Luo, Ying Xiong, Xiaoju Yang, Qiaoyue Song, Wenshuai Yu, Yaqi Yang, Ting |
author_facet | Fu, Maoling Hu, Zhenjing Yu, Genzhen Luo, Ying Xiong, Xiaoju Yang, Qiaoyue Song, Wenshuai Yu, Yaqi Yang, Ting |
author_sort | Fu, Maoling |
collection | PubMed |
description | Extubation failure (EF) is a significant concern in mechanically ventilated newborns, and predicting its occurrence is an ongoing area of research. To investigate the predictors of EF in newborns undergoing planned extubation, we conducted a systematic review and meta-analysis. A systematic literature search was conducted in PubMed, Web of Science, Embase, and Cochrane Library for studies published in English from the inception of each database to March 2023. The PRISMA guidelines were followed in all phases of this systematic review. The Risk of Bias Assessment for Nonrandomized Studies tool was used to assess methodological quality. Thirty-four studies were included, 10 of which were overall low risk of bias, 15 of moderate risk of bias, and 9 of high risk of bias. The studies reported 43 possible predictors in six broad categories (intrinsic factors; maternal factors; diseases and adverse conditions of the newborn; treatment of the newborn; characteristics before and after extubation; and clinical scores and composite indicators). Through a qualitative synthesis of 43 predictors and a quantitative meta-analysis of 19 factors, we identified five definite factors, eight possible factors, and 22 unclear factors related to EF. Definite factors included gestational age, sepsis, pre-extubation pH, pre-extubation FiO(2), and respiratory severity score. Possible factors included age at extubation, anemia, inotropic use, mean airway pressure, pre-extubation PCO(2), mechanical ventilation duration, Apgar score, and spontaneous breathing trial. With only a few high-quality studies currently available, well-designed and more extensive prospective studies investigating the predictors affecting EF are still needed. In the future, it will be important to explore the possibility of combining multiple predictors or assessment tools to enhance the accuracy of predicting extubation outcomes in clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01538-0. |
format | Online Article Text |
id | pubmed-10546653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105466532023-10-04 Predictors of extubation failure in newborns: a systematic review and meta-analysis Fu, Maoling Hu, Zhenjing Yu, Genzhen Luo, Ying Xiong, Xiaoju Yang, Qiaoyue Song, Wenshuai Yu, Yaqi Yang, Ting Ital J Pediatr Review Extubation failure (EF) is a significant concern in mechanically ventilated newborns, and predicting its occurrence is an ongoing area of research. To investigate the predictors of EF in newborns undergoing planned extubation, we conducted a systematic review and meta-analysis. A systematic literature search was conducted in PubMed, Web of Science, Embase, and Cochrane Library for studies published in English from the inception of each database to March 2023. The PRISMA guidelines were followed in all phases of this systematic review. The Risk of Bias Assessment for Nonrandomized Studies tool was used to assess methodological quality. Thirty-four studies were included, 10 of which were overall low risk of bias, 15 of moderate risk of bias, and 9 of high risk of bias. The studies reported 43 possible predictors in six broad categories (intrinsic factors; maternal factors; diseases and adverse conditions of the newborn; treatment of the newborn; characteristics before and after extubation; and clinical scores and composite indicators). Through a qualitative synthesis of 43 predictors and a quantitative meta-analysis of 19 factors, we identified five definite factors, eight possible factors, and 22 unclear factors related to EF. Definite factors included gestational age, sepsis, pre-extubation pH, pre-extubation FiO(2), and respiratory severity score. Possible factors included age at extubation, anemia, inotropic use, mean airway pressure, pre-extubation PCO(2), mechanical ventilation duration, Apgar score, and spontaneous breathing trial. With only a few high-quality studies currently available, well-designed and more extensive prospective studies investigating the predictors affecting EF are still needed. In the future, it will be important to explore the possibility of combining multiple predictors or assessment tools to enhance the accuracy of predicting extubation outcomes in clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01538-0. BioMed Central 2023-10-02 /pmc/articles/PMC10546653/ /pubmed/37784184 http://dx.doi.org/10.1186/s13052-023-01538-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Fu, Maoling Hu, Zhenjing Yu, Genzhen Luo, Ying Xiong, Xiaoju Yang, Qiaoyue Song, Wenshuai Yu, Yaqi Yang, Ting Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title | Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title_full | Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title_fullStr | Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title_full_unstemmed | Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title_short | Predictors of extubation failure in newborns: a systematic review and meta-analysis |
title_sort | predictors of extubation failure in newborns: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546653/ https://www.ncbi.nlm.nih.gov/pubmed/37784184 http://dx.doi.org/10.1186/s13052-023-01538-0 |
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