Establishing a Prediction Model for Successfully Planned Endotracheal Extubation in Preterm Neonates: An Answer to Many Questions

Abstract

Objective: To establish the prediction model for successfully planned endotracheal extubation in preterm neonates.
Study Design: Prospective cohort study
Place and Duration of Study: This study was conducted at Neonatal ICUs of Fatima Memorial Hospital Lahore, from February 2023 to October 2024.
Methodology: The study included 255 preterm neonates (28–35 weeks gestation) intubated <7 days and extubated for the first time before 30 days of age. Successful extubation was labeled as no need for reintubation within 72 hours following extubation. Demographics, prenatal, and peri-extubation data were collected analyzed using multivariate logistic regression to identify independent predictors. Receiver operating characteristic (ROC) analysis assessed model discrimination, and a nomogram was constructed for individualized prediction.
Results: Of 255 neonates, 174 (68.2%) achieved successful extubation. Independent predictors included multigravida status (OR = 0.026, 95% CI: 0.002–0.356, p = 0.006), higher serum sodium levels (OR = 1.436, 95% CI: 1.108–1.862, p = 0.006), higher pre-extubation pH (OR<0.001, p = 0.001), 

Keywords: Endotracheal extubation, Endotracheal intubation, Mechanical ventilation, NICU, Preterm neonates