Outcomes of Preterm Infants Who Experienced Unplanned Extubation

Abstract

BACKGROUND:

Unplanned extubation (UE) is associated with adverse outcomes. The aim of the study was to compare the clinical outcomes in preterm infants who experienced at least one UE to those who did not experience any UE.

METHODS:

The matched cohort study compared ventilated preterm infants < 32 weeks who experienced UE to those who did not experience any UE. The main outcomes were duration of mechanical ventilation after matching, duration of hospital stay, retinopathy of prematurity (ROP) requiring intervention, and bronchopulmonary dysplasia (BPD).

RESULTS:

Forty-seven infants were included in each group. The groups were matched for mechanical ventilation duration before UE, birth gestation, and birthweight. The duration of mechanical ventilation after matching (adjusted odds ratio [aOR] 14.8 [11.2–18.4], P = <.001), the total length of stay in the hospital (aOR 16.4 [3.7–29.2], P = .01), and severe ROP (aOR 6.7 [1.7–27.0], P = .007) were significantly higher in infants who experienced UE. After adjusting for mechanical ventilation duration, UE was not associated with ROP or BPD. However, infants who spent longer time on mechanical ventilation had higher odds of developing ROP (aOR 1.1 [1.0–1.2], P = .004) and BPD (aOR 1.5 [1.1–2.1], P = .01). Sensitivity analysis including infants who had UE and managed on noninvasive respiratory support showed significant association between UE and the outcomes of duration of mechanical ventilation, hospital length of stay, ROP, and BPD.

CONCLUSIONS:

Infants who experienced UE had higher odds of spending longer time on mechanical ventilation and spent significantly more days in the hospital.