AUTHOR=Ohnstad Mari Oma , Stensvold Hans Jørgen , Pripp Are Hugo , Tvedt Christine Raaen , Jelsness-Jørgensen Lars-Petter , Astrup Henriette , Eriksen Beate Horsberg , Lunnay Mai Linn , Mreihil Khalaf , Pedersen Tanja , Rettedal Siren Irene , Selberg Terje Reidar , Solberg Rønnaug , Støen Ragnhild , Rønnestad Arild Erland 

TITLE=Associations between unit workloads and outcomes of first extubation attempts in extremely premature infants below a gestational age of 26 weeks

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1090701

DOI=10.3389/fped.2023.1090701

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>The objective was to explore whether high workloads in neonatal intensive care units were associated with short-term respiratory outcomes of extremely premature (EP) infants born &lt;26 weeks of gestational age.</p></sec><sec><title>Methods</title><p>This was a population-based study using data from the Norwegian Neonatal Network supplemented by data extracted from the medical records of EP infants &lt;26 weeks GA born from 2013 to 2018. To describe the unit workloads, measurements of daily patient volume and unit acuity at each NICU were used. The effect of weekend and summer holiday was also explored.</p></sec><sec><title>Results</title><p>We analyzed 316 first planned extubation attempts. There were no associations between unit workloads and the duration of mechanical ventilation until each infant’s first extubation or the outcomes of these attempts. Additionally, there were no weekend or summer holiday effects on the outcomes explored. Workloads did not affect the causes of reintubation for infants who failed their first extubation attempt.</p></sec><sec><title>Conclusion</title><p>Our finding that there was no association between the organizational factors explored and short-term respiratory outcomes can be interpreted as indicating resilience in Norwegian neonatal intensive care units.</p></sec>