Association of unplanned extubations and neurodevelopmental outcomes in very low birthweight infants

Abstract

The objective of this study was to determine the association of unplanned extubations (UEs) in preterm infants with neurodevelopmental outcomes (NDO). This is retrospective, matched cohort study in a level IV academic NICU from 2014 to 2018. Very low birth weight infants admitted <72 h of birth, without congenital anomalies, who were ventilated for ≥1 h, and had neurodevelopmental follow-up data were included. Exposure was the occurrence of one or more UE. NDO were measured with Bayley Scales of Infant Development (3rd edition). One hundred and seventy-nine infants met inclusion criteria. Infants with a UE had a longer post-matching duration of mechanical ventilation (median 11 vs. 4 days) compared to controls. Cases had similar motor composite scores (aOR = 0.58, 95% CI = [0.25–1.38]) but lower cognitive scores in adjusted models (aOR 0.34, 95% CI 0.14–0.8). Unplanned extubations were associated with poorer cognitive outcomes but were not associated with poorer motor or language outcomes.