Association of time of day and extubation success in very low birthweight infants: a multicenter cohort study

Objective To determine the association of overnight extubation (OE) with extubation success. Study design Retrospective cohort study in three NICUs from 2016 to 2020. Infants without congenital anomalies, less than 1500 grams at birth, who were ventilated and received an extubation attempt were incl...

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Bibliographic Details
Published in:Journal of perinatology 2021-10, Vol.41 (10), p.2532-2536
Main Authors: Guy, Brittany, Dye, Mary Eva, Richards, Laura, Guthrie, Scott O., Hatch, L. Dupree
Format: Article
Language:English
Subjects:
692/308/174
692/308/409
Artificial respiration
Birth weight
Birth weight, Low
Care and treatment
Cohort analysis
Congenital anomalies
Congenital defects
Daytime
Extubation
Health aspects
Infants
Infants (Premature)
Management
Markers
Mechanical ventilation
Medicine
Medicine & Public Health
Methods
Neonatal intensive care
Patient outcomes
Pediatric research
Pediatric Surgery
Pediatrics
Premature birth
Success
Time of use
Ventilation
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Summary:Objective To determine the association of overnight extubation (OE) with extubation success. Study design Retrospective cohort study in three NICUs from 2016 to 2020. Infants without congenital anomalies, less than 1500 grams at birth, who were ventilated and received an extubation attempt were included. Primary exposure was OE (7:00 pm–6:59 am) and outcome was extubation success defined as no mechanical ventilation for at least 7 days after extubation. Results A total of 76/379 (20%) infants received OE. Infants extubated during the daytime were older and had higher illness severity markers. Extubation success rates did not differ for overnight (57/76, 75%) versus daytime extubations (231/303, 76%) after adjusting for confounders (adjusted relative risk 0.95, 95% CI 0.82–1.11). Conclusion Though infants in our cohort undergoing daytime and OE were dissimilar, extubation success rates did not differ. Larger multicenter studies are needed to test our findings and identify markers of extubation readiness in preterm infants.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-021-01168-6