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Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants

BACKGROUND: Very preterm infants often require mechanical ventilation. However, objective criteria to predict the outcomes of extubation in very premature neonates remain lacking. The aim of this study was to investigate the accuracy of the spontaneous breathing trial (SBT) using a combined model of...

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Autores principales: Li, Zhe, Xue, Jiang, Guo, Xin-Yuan, Wang, Fang, Zhang, Xue, Li, Qi, Tang, Jing-Liang, Ji, Juan, Du, Guang-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632075/
https://www.ncbi.nlm.nih.gov/pubmed/36324104
http://dx.doi.org/10.1186/s12887-022-03642-2
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author Li, Zhe
Xue, Jiang
Guo, Xin-Yuan
Wang, Fang
Zhang, Xue
Li, Qi
Tang, Jing-Liang
Ji, Juan
Du, Guang-Jun
author_facet Li, Zhe
Xue, Jiang
Guo, Xin-Yuan
Wang, Fang
Zhang, Xue
Li, Qi
Tang, Jing-Liang
Ji, Juan
Du, Guang-Jun
author_sort Li, Zhe
collection PubMed
description BACKGROUND: Very preterm infants often require mechanical ventilation. However, objective criteria to predict the outcomes of extubation in very premature neonates remain lacking. The aim of this study was to investigate the accuracy of the spontaneous breathing trial (SBT) using a combined model of continuous positive airway pressure (CPAP) and low-level pressure support ventilation (PSV) to predict the extubation outcomes of preterm infants with gestational age < 32 weeks. METHODS: Preterm infants with gestational age < 32 weeks, birth weight < 1500 g and requiring mechanical ventilation were selected for the study. All infants underwent a 10-minute SBT using CPAP combined with low-level PSV prior to the planned extubation. Then, the infants were extubated within 1 h after SBT. The outcomes of extubation were considered successful if the neonates did not require reintubation 72 h after extubation. RESULTS: A total of 119 eligible preterm infants were enrolled in the study, with a median gestational age of 28.9 (27.1–30.3) weeks and a median birth weight of 1100 (900–1350) g. In total, 101 of all infants had successful extubation, 18 of whom failed and eventually had to be reintubated. Of the 102 infants who achieved SBT, 99 were successfully extubated, and 15 of the 17 infants who did not pass SBT had failed extubation. Finally, the diagnostic value for SBT could be assessed with a sensitivity of 98%, a specificity of 83.3%, a positive predictive value of 97.1% and a negative predictive value of 88.2%. CONCLUSION: SBT using a combined CPAP + low-level PSV model can predict the outcomes of extubation in very preterm infants with high sensitivity and specificity.
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spelling pubmed-96320752022-11-04 Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants Li, Zhe Xue, Jiang Guo, Xin-Yuan Wang, Fang Zhang, Xue Li, Qi Tang, Jing-Liang Ji, Juan Du, Guang-Jun BMC Pediatr Research BACKGROUND: Very preterm infants often require mechanical ventilation. However, objective criteria to predict the outcomes of extubation in very premature neonates remain lacking. The aim of this study was to investigate the accuracy of the spontaneous breathing trial (SBT) using a combined model of continuous positive airway pressure (CPAP) and low-level pressure support ventilation (PSV) to predict the extubation outcomes of preterm infants with gestational age < 32 weeks. METHODS: Preterm infants with gestational age < 32 weeks, birth weight < 1500 g and requiring mechanical ventilation were selected for the study. All infants underwent a 10-minute SBT using CPAP combined with low-level PSV prior to the planned extubation. Then, the infants were extubated within 1 h after SBT. The outcomes of extubation were considered successful if the neonates did not require reintubation 72 h after extubation. RESULTS: A total of 119 eligible preterm infants were enrolled in the study, with a median gestational age of 28.9 (27.1–30.3) weeks and a median birth weight of 1100 (900–1350) g. In total, 101 of all infants had successful extubation, 18 of whom failed and eventually had to be reintubated. Of the 102 infants who achieved SBT, 99 were successfully extubated, and 15 of the 17 infants who did not pass SBT had failed extubation. Finally, the diagnostic value for SBT could be assessed with a sensitivity of 98%, a specificity of 83.3%, a positive predictive value of 97.1% and a negative predictive value of 88.2%. CONCLUSION: SBT using a combined CPAP + low-level PSV model can predict the outcomes of extubation in very preterm infants with high sensitivity and specificity. BioMed Central 2022-10-31 /pmc/articles/PMC9632075/ /pubmed/36324104 http://dx.doi.org/10.1186/s12887-022-03642-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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 Research
Li, Zhe
Xue, Jiang
Guo, Xin-Yuan
Wang, Fang
Zhang, Xue
Li, Qi
Tang, Jing-Liang
Ji, Juan
Du, Guang-Jun
Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title_full Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title_fullStr Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title_full_unstemmed Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title_short Accuracy of the spontaneous breathing trial using a combined CPAP + PSV model to predict extubation outcomes in very preterm infants
title_sort accuracy of the spontaneous breathing trial using a combined cpap + psv model to predict extubation outcomes in very preterm infants
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632075/
https://www.ncbi.nlm.nih.gov/pubmed/36324104
http://dx.doi.org/10.1186/s12887-022-03642-2
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