Trial reportIndian pediatrics2026
Neonatal Extubation Failure Prevention Trial Using Nebulised Epinephrine (NEPTUNE): A Randomized Controlled Trial.
Trial report in Indian pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- NEPTUNE Trial: Methodological Considerations and Unanswered Questions.Indian pediatrics · 2026Article
- Can Nebulized Epinephrine Prevent Extubation Failure in Neonates?Indian pediatrics · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate whether epinephrine nebulization, when used in addition to standard care, reduces extubation failure (EF) in term and preterm neonates.
methodsA parallel, randomized controlled superiority trial was conducted in a tertiary-care neonatal intensive care unit (NICU) between May 2023 and July 2024. Due to the nature of the intervention, blinding was not feasible. A total of 158 ventilated neonates (ventilation duration: 48 h to 2 weeks) were enrolled at the point of planned extubation and randomized to either the standard care group (SG) or the epinephrine nebulization group (EG). The primary outcome was extubation failure, defined as the need for reintubation within 48 h. Secondary outcomes included reintubation beyond 48 h, time to reintubation, serial Silverman-Anderson scores post-extubation, incidence of laryngeal edema, duration of non-invasive respiratory support, post-extubation and total hospital stay, mortality, and adverse effects.
resultsThe incidence of EF within 48 h was not significantly different in the EG and SG groups (14.8% vs 24.7%; P = 0.119) by intention-to-treat analysis. Per-protocol analysis showed EF of 9.2% in EG vs 24.7% in SG (P = 0.020). The post-extubation Silverman-Anderson scores showed no significant differences at immediate, 4, 8, or 12-h assessments; however, at 24 h, the EG demonstrated significantly lower scores suggestive of lesser respiratory distress compared with the SG [2.13 (1.06) vs 2.62 (1.40); P = 0.030]. Rates of laryngeal edema, adverse events including tachycardia, hypertension, peripheral vasoconstriction, ventilator-associated pneumonia, and antibiotic requirement did not differ significantly between groups.
conclusionEpinephrine nebulization administered after extubation did not reduce the incidence of extubation failure in ventilated neonates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.