Objective To study the clinical characteristics of premature infants with respiratory distress syndrome(RDS)by tracheal intubation mechanical ventilation,analyze the risk factors and adverse outcomes of extubation failure,and provide evidence for its prevention.Methods The clinical data from preterm infants(＜32 weeks gestational age)ad-mitted to Neonatal Intensive Care Unit(NICU)of the First Affiliated Hospital of Bengbu Medical University from June 2017 to December 2022 were reviewed and analyzed.According to the outcome of tracheal intubation and extubation,they were divided into a successful group and a failed group.The risk factors for extubation failure were analyzed,and the clinical progression and outcomes of the two groups were compared.Results A total of 153 premature infants with RDS were included,with 128 infants in the successful extubation group and 25 infants(16.3％)in the failed extubation group.Logistic regression analysis identified the following significant risk factors for extubation failure:low birth weight(OR=9.215,95％CI:1.153-73.611,P＜0.05),and low 5-minute Apgar score(OR=2.769,95％CI:1.681-4.563,P＜0.05),no caffeine use(OR=46.353,95％CI:3.489-615.792,P＜0.05),high PaCO2 before extubation(OR=0.871,95％CI:0.809-0.938,P＜0.05),and low Pa02 before extubation(OR=1.058,95％CI:1.018-1.101,P＜0.05).The rates of death or abandonment of treatment,ventilator-associated pneumonia(VAP),and bron-chopulmonary dysplasia(BPD)were higher in the failed group(P＜0.05).Additionally,the failed group required lon-ger oxygen therapy compared to the successful group(P＜0.05).Conclusion Lower birth weight,lower 5-minute Apgar score,no caffeine use,elevated PaCO2,and reduced PaO2 are significant predictors of extubation failure in premature in-fants with RDS.Extubation failure increases the risk of death and adverse outcomes in these infants.
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