Brittany Guy1, Mary Eva Dye2,3, Laura Richards4, Scott O Guthrie2,4, L Dupree Hatch5,6,7. 1. Meharry Medical College, Nashville, TN, USA. 2. Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. 3. Vanderbilt University School of Nursing, Nashville, TN, USA. 4. Department of Pediatrics, Jackson-Madison County General Hospital, Jackson, TN, USA. 5. Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Leon.d.hatch@vumc.org. 6. Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA. Leon.d.hatch@vumc.org. 7. Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA. Leon.d.hatch@vumc.org.
Abstract
OBJECTIVE: To determine the association of overnight extubation (OE) with extubation success. STUDY DESIGN: Retrospective cohort study in three NICUs from 2016 to 2020. Infants without congenital anomalies, less than 1500 grams at birth, who were ventilated and received an extubation attempt were included. Primary exposure was OE (7:00 pm-6:59 am) and outcome was extubation success defined as no mechanical ventilation for at least 7 days after extubation. RESULTS: A total of 76/379 (20%) infants received OE. Infants extubated during the daytime were older and had higher illness severity markers. Extubation success rates did not differ for overnight (57/76, 75%) versus daytime extubations (231/303, 76%) after adjusting for confounders (adjusted relative risk 0.95, 95% CI 0.82-1.11). CONCLUSION: Though infants in our cohort undergoing daytime and OE were dissimilar, extubation success rates did not differ. Larger multicenter studies are needed to test our findings and identify markers of extubation readiness in preterm infants.
OBJECTIVE: To determine the association of overnight extubation (OE) with extubation success. STUDY DESIGN: Retrospective cohort study in three NICUs from 2016 to 2020. Infants without congenital anomalies, less than 1500 grams at birth, who were ventilated and received an extubation attempt were included. Primary exposure was OE (7:00 pm-6:59 am) and outcome was extubation success defined as no mechanical ventilation for at least 7 days after extubation. RESULTS: A total of 76/379 (20%) infants received OE. Infants extubated during the daytime were older and had higher illness severity markers. Extubation success rates did not differ for overnight (57/76, 75%) versus daytime extubations (231/303, 76%) after adjusting for confounders (adjusted relative risk 0.95, 95% CI 0.82-1.11). CONCLUSION: Though infants in our cohort undergoing daytime and OE were dissimilar, extubation success rates did not differ. Larger multicenter studies are needed to test our findings and identify markers of extubation readiness in preterm infants.