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Endotracheal tube exchange in preterm infants with evolving chronic lung disease: safety, outcomes, and impacts on pulmonary mechanics

Journal of Perinatology volume 46, pages 38–42 (2026)Cite this article

Subjects

Abstract

Objective

A study of the safety of endotracheal tube exchange and its impact on pulmonary mechanics in preterm infants with chronic lung disease.

Study design

This retrospective cohort study included 67 infants born at less than 29 weeks gestational age who underwent endotracheal (ETT) exchange after 28 days of life in a Level 4 NICU between 2017 and 2023. Descriptive analysis was performed using the Wilcoxon rank-sum test and Chi-squared or Fisher’s exact tests to characterize the cohort and compare variables before and after the ETT exchange.

Results

ETT exchange led to increased stability in 60% of cases, while adverse events occurred in 57% of exchanges. By 36 weeks postmenstrual age, 92% of the cohort developed type 2 or 3 bronchopulmonary dysplasia (BPD).

Conclusion

The majority of ETT exchanges resulted in increased stability; however, the adverse event rate was high. Further studies are needed to determine whether ETT exchange improves long-term outcomes.

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Fig. 1: Safety and efficacy of ETT exchange in preterm infants.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA

    Mackenzie Parker, Rebecca Shay, Blair W. Weikel & Kathleen Hannan

Authors
  1. Mackenzie Parker
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  2. Rebecca Shay
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  3. Blair W. Weikel
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  4. Kathleen Hannan
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Contributions

MP, RS, BW, and KH conceptualized and designed the study. RS and KH curated the data. MP and KH performed the investigation and wrote the manuscript. BW, MP, and KH performed data analysis. RS and KH supervised and provided oversight for the study.

Corresponding author

Correspondence to Mackenzie Parker.

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Competing interests

The authors have no conflicts of interest to disclose.

Ethics approval and consent to participate

The study was approved by Colorado Multiple Institutional Review Board as secondary use of information collected for clinical care and informed consent was not required. The study was performed in accordance with the relevant guidelines and regulations including in accordance with the Declaration of Helsinki.

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Parker, M., Shay, R., Weikel, B.W. et al. Endotracheal tube exchange in preterm infants with evolving chronic lung disease: safety, outcomes, and impacts on pulmonary mechanics. J Perinatol 46, 38–42 (2026). https://doi.org/10.1038/s41372-025-02411-0

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