Dr. Wissam Shalish, McGill University Health Centre, Montréal, QC

Mechanical ventilation is a vital component of the initial respiratory management of extremely preterm infants, but its prolonged use is associated with significant harms. In an attempt to limit the duration of mechanical ventilation, clinicians strive to extubate these infants as early as deemed possible. Unfortunately, the extubation process has proven very challenging, with practices often being highly variable and reintubation rates ranking amongst the highest across all age groups. In this presentation, the complexities surrounding extubation in extremely preterm infants will be reviewed and will also attempt to decipher some of the current gaps in knowledge on this subject. An emphasis will be placed on understanding the prevalence, causes and consequences of extubation failure and provide an evidence-based approach towards assessment of extubation readiness in this high-risk population.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • understand the prevalence, causes and consequences of extubation failure in extremely preterm infants; and
  • review the evidence surrounding assessment of extubation readiness in extremely preterm infants.