Article Text

other Versions

PDF
Difficult extubation in low birth weight infants
  1. Anne Greenough (anne.greenough{at}kcl.ac.uk)
  1. Kings College London, United Kingdom
    1. Michael Prendergast (michael.prendergast{at}kcl.ac.uk)
    1. King's College London, United Kingdom

      Abstract

      • Randomised trials have demonstrated that ventilation techniques which support every spontaneous breath are the most efficacious weaning modes.

      • Nasal CPAP post extubation reduces the likelihood of incidents leading to the need for reintubation in VLBW infants; further work is needed to determine if there are advantages of particular delivery techniques.

      • Both methylxanthines and dexamethasone facilitate weaning and extubation; dexamethasone given systemically is effective even when given 21 days or more after birth; the efficacy of low dose dexamethasone merits further investigation.

      • Assessments of the efficacy of respiratory efforts and hence the balance of respiratory drive, muscle performance and respiratory load appear to best predict weaning and extubation success.

      • Essential to the success of weaning and extubation is dedicated staff, whether this will be facilitated by computerised decision making tools requires testing.

      • Whether adequate nutrition during mechanical ventilation influences the success of extubation merits investigation.

      • The above approaches are not mutually exclusive and those indicated by this review as appropriately evidence based should be considered by practitioners for current use to reduce difficult/unsuccessful extubation.

      • extubation
      • low birthweight
      • mechanical ventilation
      • prematurity
      • weaning

      Statistics from Altmetric.com

      Request permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.