RT Journal Article
SR Electronic
T1 Prediction of infant extubation success using the diaphragmatic electromyography (EMG) signal during a spontaneous breathing test (SBT)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA3955
DO 10.1183/13993003.congress-2021.OA3955
VO 58
IS suppl 65
A1 Fahad Muhamed Shareef Arattu Thodika
A1 Emma Williams
A1 Imogen Chappelow
A1 Theodore Dassios
A1 Anne Greenough
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/OA3955.abstract
AB Introduction: Prolonged mechanical ventilation in infants can result in ventilator associated lung injury. Premature extubation, however, can be associated with cardiorespiratory compromise. Identification of an accurate predictor of extubation success is, therefore, essential.Aim: To determine if diaphragmatic electrical activity during an SBT could predict extubation success in ventilated infants.Methods: Infants deemed ready for extubation by the clinical team were assessed. The SBT was performed when infants were on endotracheal CPAP for 5–10 minutes (mins). A failed SBT was recorded when the heart rate dropped < 100bpm or a desaturation to 85% for > 15 seconds, despite a 15% increase in FiO2. The diaphragmatic electrical activity was assessed using surface electrodes 10 mins pre, during and 10 mins post SBT. The clinical team were unaware of the SBT or the diaphragmatic EMG analysis results. Infants failed extubation if they were reintubated within 48 hours.Results: Twenty-eight infants, median (IQR) gestational age of 26.9 (25.2-28.4) weeks and post menstrual age (PMA) 30.5 (27.9–35.4) weeks, were studied. During the SBT, the infants had increases in the mean EMG amplitude (3.6 versus 2.2 μV, p<0.001) and mean area under the curve (MAUC) (5.3 versus 4 μV.s, p<0.05). Seven infants failed extubation and had a greater percentage increase in the MAUC (40.4 versus 6.3 %, p<0.05). A 29.6% increase in the MAUC during SBT had 71.4% sensitivity and 85.7% specificity in predicting extubation failure.Conclusion: The diaphragmatic EMG signal during SBT might have a role in predicting extubation failure in ventilated infants.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA3955.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).