NORMAL SALINE NEBULIZATION IN PREVENTING EXTUBATION FAILURE IN NEONATES, A RANDOMIZED CONTROL TRIAL | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 2, Volume 25, Issue 3, July 2022, Page 2817-2831 PDF (194.19 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2022.268933 | ||||
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| Abstract | ||||
| Background: Recurrent extubation and reintubation leads to higher morbidity and can cause long-term disabilities in neonatal population. Failure of extubation may result from several factors including alveolar atelectasis, and inadequate pulmonary mechanics. Normal saline is effective and widely used inhaled therapeutic agents either alone or in combination with other agents. Aim of the work: To evaluate the effect of normal saline nebulization in prevention of reintubation in neonates admitted to Neonatal Intensive Care Units (NICUs) of Ain Shams University Hospitals over 6 months period (from 8/2021 till 2/2022). Subjects and Methods: Sixty freshly extubated neonates were randomly allocated equally into 2 groups (intervention group and control group). Intervention group receives 4 mL of 0.9% saline nebulization was given every 4 hours for maximum of 72 hours. Patients were followed clinically till discharge and using lung ultrasound. Primary outcome was reintubation within 72 hours. Results: No significant differences between both groups in demographic data (p >0.05). There was no significant difference in reintubation incidence (p=0.222), duration of respiratory support till discharge (p= 0.438) or final outcome (p=0.718) between the two groups. Length of NICU stay and need for post extubation noninvasive ventilation were significantly longer in saline group (p <0.038 &p < 0.008 respectively). Lung ultrasound scores of case group were significantly higher at enrollment and 72 hours later (p < 0.01) however, this didn’t influence incidence of reintubation or final outcome (p = 0.812 & p=0.7 respectively). Worse LUS scores significantly correlated with both longer hospital stay and duration of respiratory support (p < 0.05). Conclusion: Our data doesn’t support using saline nebulization post extubation. Using lung ultrasound might be of value in guiding clinical decisions and predicting outcomes from neonatal respiratory diseases. | ||||
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