{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:58:12Z","timestamp":1775469492020,"version":"3.50.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Infants with a high risk of extubation failure are often treated with noninvasive ventilation (NIV) or CPAP, but data on the role of these support modalities following extubation are sparse. This report describes our experience using NIV or CPAP to support infants following extubation in our pediatric ICUs (PICUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We performed a retrospective study of children &lt; 10 kg receiving postextubation NIV or CPAP in our PICUs. Data on demographics, medical history, type of support, vital signs, pulse oximetry, near-infrared spectroscopy (NIRS), gas exchange, support settings, and re-intubation were extracted from the electronic medical record. Support was classified as prophylactic if planned before extubation and rescue if initiated within 24 h of extubation. We compared successfully extubated and re-intubated subjects using chi-square test for categorical variables and Mann-Whitney test for continuous variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We studied 51 subjects, median age 44 (interquartile range 0.5\u2013242) d and weight 3.7 (3\u20134.9) kg. There were no demographic differences between groups, except those re-intubated were more likely to have had cardiac surgery prior to admission (0% vs 14%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .040). NIV was used in 31 (61%) and CPAP in 20 (39%) subjects. Prophylactic support was initiated in 25 subjects (49%), whereas rescue support was needed in 26 subjects (51%). Twenty-two subjects (43%) required re-intubation. Re-intubation rate was higher for rescue support (58% vs 28%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .032). Subjects with a pH &lt; 7.35 (4.3% vs 42.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003) and lower somatic NIRS (39 [24\u201356] vs 62 [46\u201372],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02) were more likely to be re-intubated. The inspiratory positive airway pressure, expiratory positive airway pressure, and F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      were higher in subjects who required re-intubation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      NIV or CPAP use was associated with a re-intubation rate of 43% in a heterogeneous sample of high-risk infants. Acidosis, cardiac surgery, higher F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      , lower somatic NIRS, higher support settings, and application of rescue support were associated with the need for re-intubation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.11194","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T11:30:19Z","timestamp":1690284619000},"page":"82-90","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Noninvasive Ventilation or CPAP for Postextubation Support in Small Infants"],"prefix":"10.1177","volume":"69","author":[{"given":"Andrew G","family":"Miller","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan R","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhargav S","family":"Adagarla","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlyn E","family":"Haynes","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel M","family":"Watts","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette L","family":"Muddiman","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis S","family":"Heath","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veerajalandhar","family":"Allareddy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre T","family":"Rotta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,7,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2022.02.004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000309"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001783"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001282"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02290-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.9615"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202204-0795SO"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003109"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02426-2016"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05244"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10251"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2014.07.006"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-022-03084-8"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951119000829"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31828a8964"},{"issue":"9","key":"e_1_3_2_17_2","first-page":"e0756","article-title":"Pediatric ventilation liberation: a survey of international practice among 555 pediatric intensivists","volume":"4","author":"Loberger JM","year":"2022","unstructured":"Loberger JM, , Campbell CM, , Colleti JJr, , Borasino S, , Abu-Sultaneh S, , Khemani RG. Pediatric ventilation liberation: a survey of international practice among 555 pediatric intensivists. 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