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Objective: To identify whether the results of assessment of respiratory muscle strength or respiratory load were better predictors of extubation failure in preterm infants than readily available clinical data. Patients: Thirty six infants, median gestational age 31 (range 25-36) weeks and postnatal age 3 (1-14) days; 13 were < 30 weeks of gestational age. Methods: Respiratory muscle strength was assessed by measurement of maximum inspiratory pressure generated during airway occlusion, and inspiratory load was assessed by measurement of compliance of the respiratory system. Results: Overall, seven infants failed extubation-that is, they required reintubation within 48 hours. These infants were older (p < 0.01), had a lower gestational age (p < 0.01), and generated lower maximum inspiratory pressure (p < 0.05) than the rest of the cohort. Similar results were found in the infants < 30 weeks of gestational age. Overall and in those < 30 weeks of gestational age, gestational age and postnatal age had the largest areas under the receiver operator characteristic curves. Conclusion: In very premature infants, low gestational age and older postnatal age are better predictors of extubation failure than assessment of respiratory muscle strength or respiratory load.

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HighlightsConsistency in group level (continuity) and individual level (stability) was examined longitudinally for caregiving principles (structure and attunement) and cognitions (categorical thinking, perspectivist thinking, complexity of thought) in mothers of preterm and term infants from birth to 5 months old.Attunement was continuous and stable in mothers of preterm and term infants.Structure was continuous in both groups but stable only in mothers of term infants.Complexity of thought was continuous in both groups, perspectivist thinking increased in both groups but only for first-time mothers, and categorical thinking increased only in mothers of preterm infants.Categorical thinking, perspectivist thinking, and complexity of thought were stable in mothers of both preterm and term infants.

We have confirmed the presence of TANEC in the UK VLBW neonatal population. Its incidence lies within the wide range described in previous reports of this phenomenon globally, though with some local variation in characteristics. Further work is needed to clarify causation, pathophysiology, and possible mechanisms of prevention of TANEC.