Researcher(s)
- Alondra Colan Morillo, Applied Molecular Biology & Biotechnology, University of Delaware
Faculty Mentor(s)
- Kelley Kovatis, Neonatology Department, ChristianaCare
Abstract
Background: Premature infants often require intubation, but prolonged mechanical ventilation is associated with adverse outcomes, including neurocognitive impairment and bronchopulmonary dysplasia (BPD). Spontaneous breathing trials (SBTs) are used to determine extubation readiness but are difficult to interpret and limited in predictive value. Therefore, respiratory inductive plethysmography (RIP), an objective, bedside measurement of work of breathing (WOB) has been proposed as an alternative to SBTs.
Methods: The retrospective portion of the study included infants born at <32 weeks admitted to the ChristianaCare Neonatal Intensive Care Unit (NICU) between January 2023 and May 2025. The goal of this study was to determine the predictive ability of SBTs. The prospective portion included intubated infants born at <32 weeks. RIP and pulse oximetry measurements were obtained before, during, and after routine SBTs. WOB measurements were compared and the predictive ability of RIP to predict extubation success and failure will be determined.
Results: Retrospective: Included 142 infants. Successfully extubated infants weighed more and were older at birth than infants that failed extubation. 86% of successfully extubated and 43% of unsuccessfully extubated infants passed the SBT. 31% of infants without SBTs were successfully extubated. SBTs have sensitivity and specificity of 90% and 39%, respectively. Prospective: To date, 3/30 infants have been studied. Data analysis is ongoing.
Conclusions: SBTs can predict success but are unable to predict extubation failure, which may result in prolonged intubation. RIP can be used to measure WOB indices during SBTs. More infant studies are needed to determine if RIP is more predictive of extubation success/failure than traditional SBTs.