Document Type : original article
Authors
1 Department of Pediatrics, School of Medicine Ayatollah Taleghani Hospital, Ilam University of Medical sciences
2 Department of Midwifery, Faculty of Nursing and Midwifery, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
3 Ayatollah Taleghani Hospital,Ilam University of Medical sciences
Abstract
Background: In addition to the benefits of mechanical ventilation, sometimes, this method is associated with complications, especially in long-term use. The present clinical trial attempted to evaluate the neonatal outcomes of three methods of self-extubation, negative pressure extubation and positive pressure extubation.
Methods: A double-blind, randomized controlled trial was conducted from 2021 to 2023, at the Ayatollah Taleghani Hospital, Ilam, Iran. The eligibility criteria were neonates who were connected to a ventilator and ready for extubation by their physician's order. In the positive pressure group, extubation was done with an expandable ambobag and squeezing the ambobag 3–4 times, slowly. Neonates in the negative pressure group were extubated using a negative pressure of 80–100 mmHg. The self-extubation group consisted of neonates who their trachea separated from a ventilator without the intervention. Data were analyzed by SPSS software version 20. A p-value of 0.05 was considered significant.
Results: Overall, 101 newborn were included in the study. The results showed a non-statistically significant differences between duration of intubation, need for oxygen after extubation, and duration of hospitalization among the neonates (P> 0.05). Re-intubation was performed for one-third of neonates. The need for re-intubation was not statistically significant difference between the groups . Conclusion: Neonatal outcomes were similar in the positive and negative pressure groups. It is recommended that neonatologists consider the use of positive pressure extubation as a useful method. Particularly in neonates who are deemed to experience adverse effects if negative pressure extube is employed.
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