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Early versus delayed extubation in extremely preterm neonates: a retrospective cohort study

Journal of Perinatology volume 40, pages 118–123 (2020)Cite this article

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Abstract

Objective

To evaluate clinical outcomes associated with extubation timing among extremely preterm neonates.

Design/Methods

Neonates <26 weeks’ GA admitted to four tertiary neonatal centers were included if they met predetermined extubation criteria within first postnatal week and classified into early extubation (≤24 h; exposure group) and delayed extubation (>24 h; control group) after meeting extubation criteria. Patients with known severe IVH and/or significant PDA prior to meeting extubation criteria were excluded.

Results

Of 197 included infants, 75 were in exposure group. Survival without BPD (aOR 1.26; 95% CI 0.62–2.56; P = 0.52) and survival without severe IVH (aOR 1.98; 95% CI 0.93–4.23; P = 0.08) were not different, adjusted for GA, SNAP, number of surfactant doses and center.

Conclusions

Extubation within 24 h of meeting extubation criteria in neonates <26 weeks’ GA was not associated with survival without BPD or survival without severe IVH. However, confounding by indication cannot be ruled out without a prospective trial.

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Funding

None specific to this study. Dr Amit Mukerji is supported by a Research Early Career Award from Hamilton Health Sciences Foundation (2019–2021). Dr Prakesh Shah is supported by an Applied Research Chair funding from the Canadian Institutes of Health Research.

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Author notes

  1. These authors contributed equally: Amit Mukerji, Abdul Razak

Authors and Affiliations

  1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Amit Mukerji & Abdul Razak

  2. Department of Pediatrics, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

    Abdul Razak

  3. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

    Akanksha Aggarwal

  4. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Eyal Jacobi & Prakesh S. Shah

  5. Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada

    May Musa, Zeina Alwahab, John Baier & Michael Narvey

Authors
  1. Amit Mukerji
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  2. Abdul Razak
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  3. Akanksha Aggarwal
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  4. Eyal Jacobi
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  9. Prakesh S. Shah
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Correspondence to Amit Mukerji.

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Mukerji, A., Razak, A., Aggarwal, A. et al. Early versus delayed extubation in extremely preterm neonates: a retrospective cohort study. J Perinatol 40, 118–123 (2020). https://doi.org/10.1038/s41372-019-0495-6

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  • DOI: https://doi.org/10.1038/s41372-019-0495-6

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