Predictors of Extubation Failure in Preterm Infants at a Tertiary Neonatal Intesive Care Unit

Background: Mechanical ventilation is a standard life-supporting intervention that is often used in respiratory care of patients with various causes of respiratory failure, especially preterm infants in neonatal intensive care units (NICUs). Despite the fact that this intervention has played a major role in saving preterm infants’ lives, the challenge that concerns neonatologists around the world is extubation failure (EF) which occurs due to the absence of specific criteria that determine extubation readiness.

Objectives: The aim of this study was to determine EF rate among intubated preterm infants ( 36 6/7weeks) admitted to Sultan Qaboos University Hospital (SQUH) NICU and determine the risk factors associated with EF among the study population.

Methods: Charts of all intubated preterm infants ( 36 6/7 weeks gestation) who were admitted to SQUH NICU from January 2013 to December 2017 were retrospectively reviewed. EF was defined as the need for re-intubation within 7 days of planned extubation. Demographic data, ventilation parameters, blood gas values and different possible risk factors of EF were collected. Statistical analysis was done using SPSS version 23.

Results: A total of 190 preterm infants were intubated in the study period from which 50 were excluded for various reasons and 140 were eligible for the study. Out of which, 106 had successful extubation while 34 failed extubation (24.3%). Gestational age 3^- (p value <0.001) one hour after extubation were significantly associated with EF.

Conclusions: Extubation failure rate in preterm infants admitted at SQUH NICU was within reported international rates. Risk factors for extubation failure were patent ductus arteriosus, gestational age