Table 3.
Characteristics of Children with Planned Extubations Within 10 Hours of Passing First Extubation Readiness Test According to Extubation Result
| Characteristic | Successful Extubation (n = 272) |
Reintubated within 24 h (n = 23) |
pa |
|---|---|---|---|
| Age at PICU admission (IQR), y | 2.5 (0.6–10.3) | 1.3 (0.2–3.3) | <0.001 |
| Female, n (%) | 123 (45) | 8 (35) | 0.41 |
| Non-Hispanic white, n/total (%) | 140/271 (52) | 14/23 (61) | 0.29 |
| Cognitive impairment (baseline PCPC score >1), n (%)b | 65 (24) | 8 (35) | 0.27 |
| Functional impairment (baseline POPC score >1), n (%)b | 77 (28) | 8 (35) | 0.56 |
| PRISM III-12 score | 7 (3–12) | 4 (0–7) | <0.001 |
| Risk of mortality based on PRISM III-12 score, % | 2.9 (1.0–9.8) | 1.3 (0.5–4.3) | <0.001 |
| Primary diagnosis category, n (%) | 0.21 | ||
| Restrictive lung disease | 162 (60) | 10 (43) | |
| Obstructive lung disease | 110 (40) | 13 (57) | |
| Days of mechanical ventilation prior to day of first ERT | 3 (1–6) | 3 (1–7) | 0.77 |
| Sedative exposure on day before first ERTc | |||
| Opioid exposure, mg/kg | 2.5 (1.1–4.7) | 2.5 (0.5–4.2) | 0.57 |
| Benzodiazepine exposure, mg/kg | 2.4 (1.1–4.4) | 2.1 (0.6–5.0) | 0.69 |
| Number of sedative classesd | 2 (2–3) | 2 (2–2) | 0.84 |
| PARDS on day of first ERT, n (%)e | 0.86 | ||
| At risk (OI <4.0 or OSI <5.0) | 230 (85) | 20 (87) | |
| Mild (OI 4.0–7.9 or OSI 5.0–7.4) | 40 (15) | 1 (4) | |
| Moderate (OI 8.0–15.9 or OSI 7.5–12.2) | 2 (<1) | 2 (9) | |
| Severe (OI ≥16.0 or OSI ≥12.3) | 0 | 0 | |
| SBS score at start of first ERT, n (%) | 0.002 | ||
| −3/−2 | 9 (3) | 0 | |
| −1/0 | 239 (90) | 17 (74) | |
| +1/+2 | 17 (6) | 6 (26) | |
| Missing | 7 | 0 | |
| Non-invasive ventilation immediately post-extubation, n (%)f | 37 (14) | 7 (30) | 0.053 |
ERT, extubation readiness test; IQR, interquartile range; OI, oxygenation index; OSI, oxygen saturation index; PARDS, pediatric acute respiratory syndrome; PCPC, Pediatric Cerebral Performance Category; PICU, pediatric intensive care unit; POPC, Pediatric Overall Performance Category; PRISM III-12, Pediatric Risk of Mortality III score from first 12 hours in the PICU; SBS, State Behavioral Scale.
Values are median (IQR) unless otherwise specified.
P values for the comparison between groups were calculated using linear, logistic, and cumulative logit regression accounting for PICU as a cluster variable using generalized estimating equations for log-transformed continuous, binary, and ordinal variables, respectively.
PCPC and POPC range from 1 to 6, with higher categories indicating greater impairment.
One child passed ERT on day 0, so no data available for day before first ERT.
Different sedative classes include opioids, benzodiazepines, α2-adrengenic agonists (dexmedetomidine or clonidine), propofol, barbiturates (pentobarbital or phenobarbital), ketamine, and chloral hydrate.
Oxygenation index was calculated as ([FIO2 × mean airway pressure]/PaO2 × 100). When an arterial blood gas measurement was not available, SpO2 was used to estimate PaO2 in order to calculate OSI ([FIO2 × mean airway pressure]/SpO2 × 100). Lower scores reflect better oxygenation.
Non-invasive ventilation includes biphasic positive airway pressure or continuous positive airway pressure ≥5 cm H2O.