Prediction of Extubation Outcome by the Spontaneous Breathing Trial
Research type
Research Study
Full title
Integrated Prediction of Extubation Outcome by the Spontaneous Breathing Trial in Newborn Infants
IRAS ID
193377
Contact name
Theodore Dassios
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Prolonged mechanical ventilation has significant adverse effects in newborn infants. Health professionals aim to limit mechanical ventilation to the minimum possible duration. On the other hand infants commonly fail extubation and require reintubation which is a traumatic invasive procedure which could further prolong the duration of ventilation. Thus, accurate prediction of readiness for extubation will incur a notable reduction in respiratory morbidity.
The spontaneous breathing trial (SBT) involves placing an infant at endotracheal continuous positive end-expiratory pressure for 5 minutes during which saturation and heart rate are closely monitored. The infant would pass the test if there is no hypoxia or bradycardia during the test. A successful SBT might predict a successful extubation, ie that the infant will not require reintubation within the next 72 hours.At King’s College Hospital the SBT forms part of routine clinical care and it's use is at the discretion of the attending physician.
The respiratory muscles play a crucial role in successful extubation. One simple way to quantify respiratory muscle function is the rate of relaxation of the inspiratory muscles which can be depicted by the rate of the decline of the airway pressure signal following a spontaneous breath. The rate of relaxation has been shown to accurately describe respiratory muscle function in non-neonatal populations. To our knowledge, the potential value of this information in predicting extubation outcome in newborn infants has not been explored.
Our hypothesis is that respiratory muscle function assessment using the rate of relaxation of the inspiratory muscles during a SBT can accurately predict extubation outcome. This prediction might stand independently for the rate of relaxation or in conjunction with parameters such as the outcome of the SBT and the variability of respiratory parameters during the SBT. This could increase the prediction accuracy of extubation outcome and thus reduce re-intubation associated respiratory morbidity.REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/2111
Date of REC Opinion
1 Feb 2016
REC opinion
Further Information Favourable Opinion