Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Predicting extubation outcomes using Heart Rate Characteristics index in preterm infants: a cohort study

Chakraborty, Mallinath, Watkins, William John, Tansey, Katherine, King, William E. and Banerjee, Sujoy 2020. Predicting extubation outcomes using Heart Rate Characteristics index in preterm infants: a cohort study. European Respiratory Journal 56 (4) , 1901755. 10.1183/13993003.01755-2019

[thumbnail of Watkins.pdf]
Preview
PDF - Accepted Post-Print Version
Download (3MB) | Preview

Abstract

A strategy of early extubation to non-invasive respiratory support in preterm infants could be boosted by the availability of a decision-support tool for clinicians. Using the Heart Rate Characteristics index (HRCi) with clinical parameters, we derived and validated predictive models for extubation readiness and success. Peri-extubation demographic, clinical and HRCi data for up to 96 h were collected from mechanically ventilated infants in the control arm of a randomised trial involving 8 neonatal centres, where clinicians were blinded to the HRCi scores. The data was used to produce a multivariable regression model for the probability of subsequent re-intubation. Additionally, a survival model was produced to estimate the probability of reintubation in the period after extubation. Of the 577 eligible infants, data from 397 infants (2/3rd) were used to derive the pre-extubation model and 180 infants for validation. The model was also fitted and validated using all combinations of training (5-centres) and test (3-centres) centres. The estimated probability for the validation episodes showed discrimination with high statistical significance, with the area under the curve of 0.72 (0.71, 0.74; p<0.001). Data from all infants were used to derive models of the predictive instantaneous hazard of re-intubation adjusted for clinical parameters. Predictive models of extubation readiness and success in real-time can be derived using physiological and clinical variables. The models from our analyses can be accessed using an online tool at www.heroscore.com/extubation/ and have the potential to inform and supplement the confidence of the clinician considering extubation in preterm infants.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: European Respiratory Society
ISSN: 0903-1936
Date of First Compliant Deposit: 15 June 2020
Date of Acceptance: 15 May 2020
Last Modified: 30 Jul 2022 16:38
URI: https://orca.cardiff.ac.uk/id/eprint/132377

Citation Data

Cited 4 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics