Research

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Research and Innovation

The TCNH partners are all academic teaching hospitals committed to excellence, providing leadership and training in research and quality improvement.

Effects of an extubation readiness test protocol at a tertiary care fully outborn NICU

  • Our retrospective analysis included 589 infants and clearly demonstrated that an extubation readiness trial (ERT)/spontaneous breathing trial(SBT) is an effective tool that can reduce extubation failure rates.
  • It can provide a consistent minimally subjective approach to determining extubation readiness and can be easily implemented into the workflow of many NICUs.
  • The study revealed a trend towards a slight reduction in mechanical ventilation days although it did not reach statistical significance.

Current practice:

The data collection and analysis informed our NICU RRT practice team to make some minor changes to the SBT/ERT in 2017:  (see attached algorithm)

  • The 10-minute trial is now a single staged CPAP+PS trial (hence the removal of the 3 min CPAP only portion)
  • The marked work of breathing component in the failure criteria was removed to assist in reducing clinician subjectivity although it may still be communicated and discussed with the medical team.

View the full article here.

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