Neonatal Diaphragmatic Activity-Linked Extubation Conditions and Timing

A Descriptive Prospective Study of Diaphragmatic Activity in Intubated Neonates Around Extubation

The objective of this study is to evaluate the role of diaphragmatic electrical activity monitoring (collected by esophageal probe) around extubation of preterm patients in order to consider its use as a standardized objective criterion to aid in the decision to extubate.

All parents of newborns meeting the inclusion criteria and without exclusion criteria will be approached for the study. If the parents do not object, the investigators will include patients once a collegial decision to extubate has been made after re-verification of the inclusion/exclusion criteria.

After patient inclusion, patient data collection by Servo-tracker will be set up, and ancillary data (treatments, Neo Comfort scale, respiratory rate, transcutaneous capnography, ventilation parameters, tidal volume) will be recorded at a given time every hour until the patient is extubated.

At the same time, the investigators will extract medical and administrative data from the patients' electronic records into a database that can only be accessed on a department computer, protected by a password.

After extubation, the patient is monitored for 7 days to assess the need for reintubation and collect data if the patient is reintubated. At the end of the 7 days or after reintubation, the patient's study follow-up is complete.

They may be included again if they are extubated again during the study period.

Inclusion Criteria:

• All newborns born at <32 weeks of amenorrhea hospitalized in the neonatal intensive care unit at CHIC
• Patient intubated and ventialted with an Edi tube in place
• Patient eligible for scheduled extubation

Exclusion Criteria:

• Absence of Edi tube
• Palliative care situation
• Patient treated with curare
• Patients with neuromuscular disorders
• Accidental extubation
• Parental refusal