TY - JOUR T1 - Does Diaphragmatic Electrical Activity in Preterm Infants Predict Extubation Success? JF - Respiratory Care SP - 203 LP - 207 DO - 10.4187/respcare.05539 VL - 63 IS - 2 AU - Neetu Singh AU - Matthew J McNally AU - Robert A Darnall Y1 - 2018/02/01 UR - http://rc.rcjournal.com/content/63/2/203.abstract N2 - BACKGROUND: Despite many advances in respiratory care and mechanical ventilation, neonatologists lack an objective tool to aid in decision making for timely extubation. Electrical activity of the diaphragm (EAdi), a measure of neural respiratory drive and inspiratory load, may be a useful predictor of extubation success in preterm neonates. The objective of this work was to investigate whether peak EAdi could distinguish successful versus failed extubation in mechanically ventilated preterm infants.METHODS: We examined peak EAdi as a predictor of extubation outcome in a convenience sample of 21 preterm infants with respiratory distress syndrome requiring mechanical ventilation. Infants were ventilated with a VN500 ventilator using volume guarantee mode and extubated per unit protocol. Peak EAdi was continuously measured with an EAdi catheter in the esophagus to obtain data at 1-min intervals for 24 h before extubation. The primary outcome was extubation success, defined as not requiring re-intubation for at least 72 h.RESULTS: Twenty one premature infants with respiratory distress syndrome included in the study had a mean ± SD) gestational age of 28 ± 2.6 weeks and mean birthweight of 1,208 ± 611 g. The first extubation attempt occurred at a median age of 1 d (interquartile range 1–2 d). One third of the infants failed the first extubation attempt. Infants with failed extubations were significantly smaller (mean ± SD birthweight 788 ± 266 g versus 1,417 ± 632 g) and of lower gestational age (mean ± SD 26 ± 1.9 weeks versus 29 ± 2.6 weeks) compared with those with successful extubation. Mean peak EAdi before extubation did not differ between the 2 groups.CONCLUSIONS: This small study suggests that the pre-extubation peak EAdi does not predict extubation success. (ClinicalTrials.gov registration NCT02144363.) ER -