When and How to Extubate Premature Infants from Mechanical Ventilation

Prolonged mechanical ventilation (MV) is associated with both short-term morbidities and neurodevelopmental impairment. The ability of clinicians to accurately predict successful extubation is limited. Extubation failure may also be associated with significant short- and long-term morbidities. There are limited conflicting data from a few studies evaluating the role of pulmonary function and autonomic nervous system function in predicting the success of elective extubations. Also, the methodology used in some studies may not be easily applied in the clinical setting. There is a need to identify good objective criteria for predicting successful extubation, which may help reduce the duration of MV as well as the incidence of failed extubation.