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Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery.

Publication ,  Journal Article
Gradidge, EA; Grimaldi, LM; Cashen, K; Gowda, KMN; Piggott, KD; Wilhelm, M; Costello, JM; Mastropietro, CW
Published in: Cardiol Young
June 2019

INTRODUCTION: Reliable predictors of extubation readiness are needed and may reduce morbidity related to extubation failure. We aimed to examine the relationship between changes in pre-extubation near-infrared spectroscopy measurements from baseline and extubation outcomes after neonatal cardiac surgery. MATERIALS AND METHODS: In this retrospective cross-sectional multi-centre study, a secondary analysis of prospectively collected data from neonates who underwent cardiac surgery at seven tertiary-care children's hospitals in 2015 was performed. Extubation failure was defined as need for re-intubation within 72 hours of the first planned extubation attempt. Near-infrared spectroscopy measurements obtained before surgery and before extubation in patients who failed extubation were compared to those of patients who extubated successfully using t-tests. RESULTS: Near-infrared spectroscopy measurements were available for 159 neonates, including 52 with single ventricle physiology. Median age at surgery was 6 days (range: 1-29 days). A total of 15 patients (9.4 %) failed extubation. Baseline cerebral and renal near-infrared spectroscopy measurements were not statistically different between those who were successfully extubated and those who failed, but pre-extubation cerebral and renal values were significantly higher in neonates who extubated successfully. An increase from baseline to time of extubation values in cerebral oximetry saturation by ≥ 5 % had a positive predictive value for extubation success of 98.6 % (95%CI: 91.1-99.8 %). CONCLUSION: Pre-extubation cerebral near-infrared spectroscopy measurements, when compared to baseline, were significantly associated with extubation outcomes. These findings demonstrate the potential of this tool as a valuable adjunct in assessing extubation readiness after paediatric cardiac surgery and warrant further evaluation in a larger prospective study.

Duke Scholars

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

June 2019

Volume

29

Issue

6

Start / End Page

787 / 792

Location

England

Related Subject Headings

  • Ventilator Weaning
  • Treatment Failure
  • Spectroscopy, Near-Infrared
  • Retrospective Studies
  • Predictive Value of Tests
  • Postoperative Care
  • Oximetry
  • Male
  • Infant, Newborn
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gradidge, E. A., Grimaldi, L. M., Cashen, K., Gowda, K. M. N., Piggott, K. D., Wilhelm, M., … Mastropietro, C. W. (2019). Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery. Cardiol Young, 29(6), 787–792. https://doi.org/10.1017/S1047951119000829
Gradidge, Eleanor A., Lisa M. Grimaldi, Katherine Cashen, Keshava M. N. Gowda, Kurt D. Piggott, Michael Wilhelm, John M. Costello, and Christopher W. Mastropietro. “Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery.Cardiol Young 29, no. 6 (June 2019): 787–92. https://doi.org/10.1017/S1047951119000829.
Gradidge EA, Grimaldi LM, Cashen K, Gowda KMN, Piggott KD, Wilhelm M, et al. Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery. Cardiol Young. 2019 Jun;29(6):787–92.
Gradidge, Eleanor A., et al. “Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery.Cardiol Young, vol. 29, no. 6, June 2019, pp. 787–92. Pubmed, doi:10.1017/S1047951119000829.
Gradidge EA, Grimaldi LM, Cashen K, Gowda KMN, Piggott KD, Wilhelm M, Costello JM, Mastropietro CW. Near-infrared spectroscopy for prediction of extubation success after neonatal cardiac surgery. Cardiol Young. 2019 Jun;29(6):787–792.
Journal cover image

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

June 2019

Volume

29

Issue

6

Start / End Page

787 / 792

Location

England

Related Subject Headings

  • Ventilator Weaning
  • Treatment Failure
  • Spectroscopy, Near-Infrared
  • Retrospective Studies
  • Predictive Value of Tests
  • Postoperative Care
  • Oximetry
  • Male
  • Infant, Newborn
  • Humans