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Short-term complications and long-term morbidities associated with repeated unplanned extubations

Journal of Perinatology volume 41, pages 562–570 (2021)Cite this article

Subjects

Abstract

Objective

To describe characteristics associated with repeated unplanned extubations, short-term complications and outcomes, and longer-term morbidities including acquired subglottic stenosis.

Study design

Cohort study including neonates admitted to a tertiary care neonatal intensive care unit who experienced an unplanned extubation in a 5-year period.

Results

We reviewed 588 events involving 300 patients. Ten percent had airway trauma with reintubation, 42% required ≥2 reintubation attempts, and 39% led to increased baseline oxygen. Increased odds of repeated events were seen in patients with bronchopulmonary dysplasia and were associated with higher rates of tracheostomy and longer length of stay. The 9% of patients diagnosed with acquired subglottic stenosis had more unplanned extubations, higher rates of airway trauma and tracheitis, and were an older gestational age at birth.

Conclusion

Unplanned extubations lead to short- and long-term morbidities. Certain patient characteristics are associated with increased odds of repeated events and the development of acquired subglottic stenosis.

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Author information

Authors and Affiliations

  1. Division of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Leeann R. Pavlek

  2. Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Leeann R. Pavlek

  3. Department of Pediatrics, Saint Louis University, St. Louis, MO, USA

    Julie Dillard

  4. Quality Improvement Services, Nationwide Children’s Hospital, Columbus, OH, USA

    Gregory Ryshen

  5. Biostatistics Resource at Nationwide Children’s Hospital, Columbus, OH, USA

    Emily Hone & Mohannad Moallem

  6. Neonatal Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Edward G. Shepherd

Authors
  1. Leeann R. Pavlek
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  2. Julie Dillard
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  3. Gregory Ryshen
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  4. Emily Hone
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  5. Edward G. Shepherd
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  6. Mohannad Moallem
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Contributions

LRP, JD, EGS, and MM conceived and designed this research; LRP, JD, and GR collected and analyzed data; EH analyzed data; LRP drafted the manuscript. All authors edited and revised the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Leeann R. Pavlek.

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The authors declare that they have no conflict of interest.

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Pavlek, L.R., Dillard, J., Ryshen, G. et al. Short-term complications and long-term morbidities associated with repeated unplanned extubations. J Perinatol 41, 562–570 (2021). https://doi.org/10.1038/s41372-021-00927-9

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