Patterns of reintubation in extremely preterm infants: A longitudinal cohort study

Wissam Shalish, Lara Kanbar, Martin Keszler, Sanjay Chawla, Lajos Kovacs, Smita Rao, Bogdan A. Panaitescu, Alyse Laliberte, Doina Precup, Karen Brown, Robert E. Kearney, Guilherme M. Sant'Anna

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

BackgroundThe optimal approach for reporting reintubation rates in extremely preterm infants is unknown. This study aims to longitudinally describe patterns of reintubation in this population over a broad range of observation windows following extubation.MethodsTiming and reasons for reintubation following a first planned extubation were collected from infants with birth weight ≤1,250 g. An algorithm was generated to discriminate between reintubations attributable to respiratory and non-respiratory causes. Frequency and cumulative distribution curves were constructed for each category using 24 h intervals. The ability of observation windows to capture respiratory-related reintubations while limiting non-respiratory reasons was assessed using a receiver operating characteristic curve.ResultsOut of 194 infants, 91 (47%) were reintubated during hospitalization; 68% for respiratory and 32% for non-respiratory reasons. Respiratory-related reintubation rates steadily increased from 0 to 14 days post-extubation before reaching a plateau. In contrast, non-respiratory reintubations were negligible in the first post-extubation week, but became predominant after 14 days. An observation window of 7 days captured 77% of respiratory-related reintubations while only including 14% of non-respiratory cases.ConclusionReintubation patterns are highly variable and affected by the reasons for reintubation and observation window used. Ideally, reintubation rates should be reported using a cumulative distribution curve over time.

Original languageEnglish
Pages (from-to)969-975
Number of pages7
JournalPediatric Research
Volume83
Issue number5
DOIs
StatePublished - May 1 2018
Externally publishedYes

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