@article {Weisz286, author = {Dany E Weisz and Eugene Yoon and Michael Dunn and Julie Emberley and Amit Mukerji and Brooke Read and Prakeshkumar S Shah}, editor = {, and , and Shah, Prakesh S and Kanungo, Jaideep and Ting, Joseph and Cieslak, Zenon and Sherlock, Rebecca and Mehrem, Ayman Abou and Toye, Jennifer and Fajardo, Carlos and Kalapesi, Zarin and Sankaran, Koravangattu and Seshia, Mary and Alvaro, Ruben and Mukerji, Amit and Silva, Orlando Da and Adie, Mohammad and Lee, Kyong-Soon and Dunn, Michael and Lemyre, Brigitte and Khurshid, Faiza and Pelausa, Ermelinda and Barrington, Keith and Ethier, Guillaume and Drolet, Christine and Piedboeuf, Bruno and Claveau, Martine and Bertelle, Valerie and Masse, Edith and Canning, Roderick and Makary, Hala and Ojah, Cecil and Monterrosa, Luis and Emberley, Julie and Afifi, Jehier and Kajetanowicz, Andrzej and Lee, Shoo K}, title = {Duration of and trends in respiratory support among extremely preterm infants}, volume = {106}, number = {3}, pages = {286--291}, year = {2021}, doi = {10.1136/archdischild-2020-319496}, publisher = {BMJ Publishing Group}, abstract = {Objective To evaluate annual trends in the administration and duration of respiratory support among preterm infants.Design Retrospective cohort study.Setting Tertiary neonatal intensive care units in the Canadian Neonatal Network.Patients 8881 extremely preterm infants born from 2010 to 2017 treated with endotracheal and/or non-invasive positive pressure support (PPS).Main outcome measures Competing risks methods were used to investigate the outcomes of mortality and time to first successful extubation, definitive extubation, weaning off PPS, and weaning PPS and/or low-flow oxygen, according to gestational age (GA). Cox proportional hazards and regression models were fitted to evaluate the trend in duration of respiratory support, survival and surfactant treatment over the study period.Results The percentages of infants who died or were weaned from respiratory support were presented graphically over time by GA. Advancing GA was associated with ordinally earlier weaning from respiratory support. Year over year, infants born at 23 weeks were initially and definitively weaned from endotracheal and all PPS earlier (HR 1.06, 95\% CI 1.01 to 1.11, for all outcomes), while survival simultaneously increased (OR 1.11, 95\% CI 1.03 to 1.18). Infants born at 26 and 27 weeks remained on non-invasive PPS longer (HR 0.97, 95\% CI 0.95 to 0.98 and HR 0.97, 95\% CI 0.95 to 0.99, respectively). Early surfactant treatment declined among infants born at 24{\textendash}27 weeks GA.Conclusions Infants at the borderline of viability have experienced improved survival and earlier weaning from all forms of PPS, while those born at 26 and 27 weeks are spending more time on PPS in recent years. GA-based estimates of the duration of respiratory support and survival may assist in counselling, benchmarking, quality improvement and resource planning.No data are available. Data are from the Canadian Neonatal Network and comprise deidentified participant data.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/106/3/286}, eprint = {https://fn.bmj.com/content/106/3/286.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }