Extubation failure in the very preterm infant

any very preterm infants require assisted ventilation. After resolution of their initial pulmonary dysfunction, when extubated they are at risk of failure due to poor respiratory drive, atelectasis, residual pulmonary function abnormalities, or intercurrent illness. Keeping such infants extubated will decrease lung injury and improve long-term pulmonary and perhaps even neurologic outcomes. On the other hand, if failure of extubation could be accurately predicted, then extubation could be deferred and the trauma of reintubation after a brief failed extubation, with increased work of breathing, hypoventilation, and respiratory acidosis, could be avoided.