{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T03:02:23Z","timestamp":1775790143453,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Respiratory Distress Syndrome (RDS) is a common cause of neonatal morbidity and mortality in premature newborns. In this study, we aim to compare the reintubation rate in preterm babies with RDS who were extubated to Nasal Continuous Positive Airway Pressure (NCPAP) versus those extubated to Nasal Intermittent Positive Pressure Ventilation (NIPPV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective study conducted in the Neonatal Intensive Care Unit (NICU) of Women\u2019s Wellness and Research Center (WWRC), Doha, Qatar. The medical files (<jats:italic>n<\/jats:italic>\u2009=\u2009220) of ventilated preterm infants with gestational age ranging between 28\u2009weeks 0\u2009days and 36\u2009weeks +\u20096\u2009days gestation and extubated to non-invasive respiratory support (whether NCPAP, NIPPV, or Nasal Cannula) during the period from January 2016 to December 2017 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the study group of 220 babies,<jats:italic>n<\/jats:italic>\u2009=\u200997 (44%) babies were extubated to CPAP,<jats:italic>n<\/jats:italic>\u2009=\u200977 (35%) were extubated to NIPPV, and<jats:italic>n<\/jats:italic>\u2009=\u200946 (21%) babies were extubated to Nasal Cannula (NC). Out of the<jats:italic>n<\/jats:italic>\u2009=\u2009220 babies, 18 (8.2%) were reintubated within 1\u00a0week after extubation. 14 of the 18 (77.8%) were reintubated within 48\u2009h of extubation. Eleven babies needed reintubation after being extubated to NCPAP (11.2%) and seven were reintubated after extubation to NIPPV (9.2%), none of those who were extubated to NC required reintubation (<jats:italic>P<\/jats:italic>\u2009=\u20090.203). The reintubation rate was not affected by extubation to any form of non-invasive ventilation (<jats:italic>P<\/jats:italic>\u2009=\u20090.625). The mode of ventilation before extubation does not affect the reintubation rate (<jats:italic>P<\/jats:italic>\u2009=\u20090.877). The presence of PDA and NEC was strongly associated with reintubation which increased by two and four-folds respectively in those morbidities. There is an increased risk of reintubation with babies suffering from NEC and BPD and this was associated with an increased risk of hospital stay with a<jats:italic>P<\/jats:italic>-value ranging (from 0.02\u20130.003). Using multivariate logistic regression, NEC the NEC (OR\u2009=\u20095.52, 95% CI 1.26, 24.11,<jats:italic>P<\/jats:italic>\u2009=\u20090.023) and the vaginal delivery (OR\u2009=\u20090.23, 95% CI 0.07, 0.78,<jats:italic>P<\/jats:italic>\u2009=\u20090.018) remained significantly associated with reintubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reintubation rates were less with NIPPV when compared with NCPAP, however, this difference was not statistically significant. This study highlights the need for further research studies with a larger number of neonates in different gestational ages birth weight categories. Ascertaining this information will provide valuable data for the factors that contribute to re-intubation rates and influence the decision-making and management of RDS patients in the future.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12887-021-02760-7","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T05:03:10Z","timestamp":1623819790000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Reintubation rates after extubation to different non-invasive ventilation modes in preterm infants"],"prefix":"10.1186","volume":"21","author":[{"given":"Alaa","family":"Masry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuha A. M. A.","family":"Nimeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olfa","family":"Koobar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer","family":"Hammoudeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prem","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Einas E.","family":"Elmalik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr M.","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasir","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazla A. M.","family":"Mahmoud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa J.","family":"Langtree","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad A. A.","family":"Bayoumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"issue":"1","key":"2760_CR1","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1542\/peds.2013-3442","volume":"133","author":"Committee on F, Newborn, American Academy of P","year":"2014","unstructured":"Committee on F, Newborn, American Academy of P. Respiratory support in preterm infants at birth. Pediatrics. 2014;133(1):171\u20134.","journal-title":"Pediatrics."},{"issue":"5","key":"2760_CR2","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1136\/archdischild-2014-306642","volume":"100","author":"S Sakonidou","year":"2015","unstructured":"Sakonidou S, Dhaliwal J. The management of neonatal respiratory distress syndrome in preterm infants (European consensus guidelines--2013 update). Arch Dis Child Educ Pract Ed. 2015;100(5):257\u20139.","journal-title":"Arch Dis Child Educ Pract Ed"},{"issue":"16 Suppl 1","key":"2760_CR3","doi-asserted-by":"publisher","first-page":"S204","DOI":"10.1161\/CIR.0000000000000276","volume":"132","author":"JM Perlman","year":"2015","unstructured":"Perlman JM, Wyllie J, Kattwinkel J, Wyckoff MH, Aziz K, Guinsburg R, et al. Part 7: neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2015;132(16 Suppl 1):S204\u201341.","journal-title":"Circulation."},{"key":"2760_CR4","first-page":"CD003212","volume":"9","author":"B Lemyre","year":"2014","unstructured":"Lemyre B, Davis PG, De Paoli AG, Kirpalani H. Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation. Cochrane Database Syst Rev. 2014;9:CD003212.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"2760_CR5","doi-asserted-by":"publisher","first-page":"F98","DOI":"10.1136\/archdischild-2011-301266","volume":"98","author":"E Bancalari","year":"2013","unstructured":"Bancalari E, Claure N. The evidence for non-invasive ventilation in the preterm infant. Arch Dis Child Fetal Neonatal Ed. 2013;98(2):F98\u2013F102.","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2760_CR6","doi-asserted-by":"crossref","unstructured":"Cummings JJ, Polin RA, Committee on F, Newborn AAoP. Noninvasive Respiratory Support. Pediatrics. 2016;137(1):e20153758.","DOI":"10.1542\/peds.2015-3758"},{"issue":"2","key":"2760_CR7","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S0378-3782(99)00046-8","volume":"56","author":"C Moretti","year":"1999","unstructured":"Moretti C, Gizzi C, Papoff P, Lampariello S, Capoferri M, Calcagnini G, et al. Comparing the effects of nasal synchronized intermittent positive pressure ventilation (nSIPPV) and nasal continuous positive airway pressure (nCPAP) after extubation in very low birth weight infants. Early Hum Dev. 1999;56(2):167\u201377.","journal-title":"Early Hum Dev"},{"issue":"2","key":"2760_CR8","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1001\/jamapediatrics.2016.3015","volume":"171","author":"KN Ferguson","year":"2017","unstructured":"Ferguson KN, Roberts CT, Manley BJ, Davis PG. Interventions to improve rates of successful Extubation in preterm infants: a systematic review and Meta-analysis. JAMA Pediatr. 2017;171(2):165\u201374.","journal-title":"JAMA Pediatr"},{"issue":"1","key":"2760_CR9","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s13052-019-0707-x","volume":"45","author":"DL Permall","year":"2019","unstructured":"Permall DL, Pasha AB, Chen XQ. Current insights in non-invasive ventilation for the treatment of neonatal respiratory disease. Ital J Pediatr. 2019;45(1):105.","journal-title":"Ital J Pediatr"},{"issue":"5","key":"2760_CR10","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1038\/jp.2012.1","volume":"32","author":"R Ramanathan","year":"2012","unstructured":"Ramanathan R, Sekar KC, Rasmussen M, Bhatia J, Soll RF. Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress syndrome in preterm infants <30 weeks\u2019 gestation: a randomized, controlled trial. J Perinatol. 2012;32(5):336\u201343.","journal-title":"J Perinatol"},{"key":"2760_CR11","first-page":"CD003212","volume":"2","author":"B Lemyre","year":"2017","unstructured":"Lemyre B, Davis PG, De Paoli AG, Kirpalani H. Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation. Cochrane Database Syst Rev. 2017;2:CD003212.","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"2760_CR12","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","volume":"163","author":"AH Jobe","year":"2001","unstructured":"Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723\u20139.","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"2760_CR13","first-page":"213","volume":"17","author":"RM Kliegman","year":"1987","unstructured":"Kliegman RM, Walsh MC. Neonatal necrotizing enterocolitis: pathogenesis, classification, and spectrum of illness. Curr Probl Pediatr. 1987;17(4):213\u201388.","journal-title":"Curr Probl Pediatr"},{"issue":"2","key":"2760_CR14","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1159\/000506988","volume":"117","author":"A Smith","year":"2020","unstructured":"Smith A, El-Khuffash AF. Defining \"Haemodynamic significance\" of the patent ductus arteriosus: do we have all the answers? Neonatology. 2020;117(2):225\u201332.","journal-title":"Neonatology."},{"issue":"6","key":"2760_CR15","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1038\/s41390-019-0342-7","volume":"85","author":"A El-Khuffash","year":"2019","unstructured":"El-Khuffash A, Levy PT, Gorenflo M, Frantz ID 3rd. The definition of a hemodynamically significant ductus arteriosus. Pediatr Res. 2019;85(6):740\u20131.","journal-title":"Pediatr Res"},{"issue":"5","key":"2760_CR16","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1038\/pr.2017.330","volume":"83","author":"W Shalish","year":"2018","unstructured":"Shalish W, Kanbar L, Keszler M, Chawla S, Kovacs L, Rao S, et al. Patterns of reintubation in extremely preterm infants: a longitudinal cohort study. Pediatr Res. 2018;83(5):969\u201375.","journal-title":"Pediatr Res"},{"issue":"6","key":"2760_CR17","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.5114\/aoms.2020.93541","volume":"16","author":"H Cao","year":"2020","unstructured":"Cao H, Li H, Zhu X, Wang L, Yi M, Li C, et al. Three non-invasive ventilation strategies for preterm infants with respiratory distress syndrome: a propensity score analysis. Arch Med Sci. 2020;16(6):1319\u201326.","journal-title":"Arch Med Sci"},{"key":"2760_CR18","unstructured":"Chico MN, Saudamini, Rao S, Chandrasekaran A, Bhat S. Predictors of Extubation Failure in Mechanically Ventilated Neonates in the NICU. Perinatology. 2018;19(1)."},{"issue":"1","key":"2760_CR19","doi-asserted-by":"publisher","first-page":"51","DOI":"10.5935\/0103-507X.20140008","volume":"26","author":"Costa ACdO, Schettino RdC, Ferreira","year":"2014","unstructured":"Costa ACdO, Schettino RdC, Ferreira SC. Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation. Rev Bras Ter Intensiva. 2014;26(1):51\u20136.","journal-title":"Rev Bras Ter Intensiva"},{"issue":"1","key":"2760_CR20","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/j.1442-200X.2007.02525.x","volume":"50","author":"C Moretti","year":"2008","unstructured":"Moretti C, Giannini L, Fassi C, Gizzi C, Papoff P, Colarizi P. Nasal flow-synchronized intermittent positive pressure ventilation to facilitate weaning in very low-birthweight infants: unmasked randomized controlled trial. Pediatr Int. 2008;50(1):85\u201391.","journal-title":"Pediatr Int"},{"key":"2760_CR21","doi-asserted-by":"crossref","unstructured":"Solevag AL, Cheung PY, Schmolzer GM. Bi-level noninvasive ventilation in neonatal respiratory distress syndrome. A Systematic Review and Meta-Analysis. Neonatology. 2021:1\u201310.","DOI":"10.1159\/000514637"},{"key":"2760_CR22","doi-asserted-by":"publisher","unstructured":"El-Farrash RA, DiBlasi RM, Abd ELAEA, El-Tahry AM, Eladawy MS, Tadros MA, et al. Postextubation noninvasive ventilation in respiratory distress syndrome: a randomized controlled trial. Am J Perinatol. 2021. https:\/\/doi.org\/10.1055\/s-0041-1723999.","DOI":"10.1055\/s-0041-1723999"},{"key":"2760_CR23","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.jpeds.2017.04.050","volume":"189","author":"S Chawla","year":"2017","unstructured":"Chawla S, Natarajan G, Shankaran S, Carper B, Brion LP, Keszler M, et al. Markers of successful Extubation in extremely preterm infants, and morbidity after failed Extubation. J Pediatr. 2017;189:113\u20139 e2.","journal-title":"J Pediatr"},{"key":"2760_CR24","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.jpeds.2016.02.016","volume":"173","author":"BJ Manley","year":"2016","unstructured":"Manley BJ, Doyle LW, Owen LS, Davis PG. Extubating extremely preterm infants: predictors of success and outcomes following failure. J Pediatr. 2016;173:45\u20139.","journal-title":"J Pediatr"},{"issue":"5","key":"2760_CR25","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1590\/S0021-75572009000500005","volume":"85","author":"F Hermeto","year":"2009","unstructured":"Hermeto F, Martins BM, Ramos JR, Bhering CA, Sant'Anna GM. Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams. J Pediatr. 2009;85(5):397\u2013402.","journal-title":"J Pediatr"},{"issue":"2","key":"2760_CR26","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3233\/NPM-171647","volume":"10","author":"K Al-Hathlol","year":"2017","unstructured":"Al-Hathlol K, Bin Saleem N, Khawaji M, Al Saif S, Abdelhakim I, Al-Hathlol B, et al. Early extubation failure in very low birth weight infants: clinical outcomes and predictive factors. J Neonatal-Perinatal Med. 2017;10(2):163\u20139.","journal-title":"J Neonatal-Perinatal Med"},{"key":"2760_CR27","doi-asserted-by":"crossref","unstructured":"Teixeira RF, Costa CM, Maria de Abreu C, Lessa CA, Carvalho AC, Kassar SB, et al. Factors associated with extubation failure in very low birth weight infants: a cohort study in the northeast Brazil. J Perinat Med. 2020;49(4):506\u201313.","DOI":"10.1515\/jpm-2020-0313"},{"issue":"Suppl 1","key":"2760_CR28","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/1742-4755-10-S1-S2","volume":"10","author":"H Blencowe","year":"2013","unstructured":"Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10(Suppl 1):S2.","journal-title":"Reprod Health"},{"issue":"6198","key":"2760_CR29","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1126\/science.1251816","volume":"345","author":"R Romero","year":"2014","unstructured":"Romero R, Dey SK, Fisher SJ. Preterm labor: one syndrome, many causes. Science. 2014;345(6198):760\u20135.","journal-title":"Science."},{"issue":"2","key":"2760_CR30","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/JCMA.0000000000000228","volume":"83","author":"ZL Cao","year":"2020","unstructured":"Cao ZL, Pan JJ, Shen X, Zhou XY, Cheng R, Zhou XG, et al. Less invasive surfactant administration in preterm infants with respiratory distress syndrome-an updated meta-analysis. J Chin Med Assoc. 2020;83(2):170\u20139.","journal-title":"J Chin Med Assoc"},{"issue":"7","key":"2760_CR31","first-page":"721","volume":"22","author":"MY Huo","year":"2020","unstructured":"Huo MY, Mei H, Zhang YH, Liu CZ, Hu YN, Song D. Efficacy and safety of less invasive surfactant administration in the treatment of neonatal respiratory distress syndrome: a Meta analysis. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(7):721\u20137.","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"issue":"1","key":"2760_CR32","doi-asserted-by":"publisher","first-page":"F17","DOI":"10.1136\/archdischild-2015-310299","volume":"102","author":"JC Aldana-Aguirre","year":"2017","unstructured":"Aldana-Aguirre JC, Pinto M, Featherstone RM, Kumar M. Less invasive surfactant administration versus intubation for surfactant delivery in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2017;102(1):F17\u201323.","journal-title":"Arch Dis Child Fetal Neonatal Ed"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-02760-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-021-02760-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-02760-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T08:24:15Z","timestamp":1672475055000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-021-02760-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,16]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2760"],"URL":"https:\/\/doi.org\/10.1186\/s12887-021-02760-7","relation":{},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,16]]},"assertion":[{"value":"17 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This research was approved by the Institutional Review Board (IRB) of the Medical Research Center (Protocol number MRC-01-18-321), Hamad Medical Corporation, Doha, Qatar. A waiver for the requirement of informed consent from the mothers whose records were analyzed was granted by the Chair of the Medical Research Center on the grounds of being a minimal risk study. All methods were performed following the relevant guidelines and regulations. The author signs for and accepts responsibility for releasing this material on behalf of all co-authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"281"}}