The blind have generally been considered to be a homogeneous population whose deficits arise from an interaction of loss of vision, age of onset and socialization. Sequelae are posited to exist merely due to the limiting effects of blindness on experience. This is believed to affect all blind persons equally regardless of cause of blindness provided that independent secondary disabilities do not exist. This study investigated the possibility that different causes of blindness are related to specific neuropsychological deficits which cannot be explained by the mere presence of blindness. It was found that neuropsychological differences existed among specific sub-populations of blind persons. These results suggested that the cause of blindness may be a marker for specific Central Nervous System involvement.

La prématurité est un problème de santé publique mondial qui affecte aujourd'hui 1 sur 10 enfants chaque année. En France, ce phénomène a régulièrement augmenté, les prématurés représentant 7,3% des nouveaux nés français en 2014, contre 5,9% en 1995. Des recherches scientifiques ont établi que les enfants nés prématurément sont plus susceptibles de rencontrer des difficultés dans le développement langagier ainsi que dans d'autres domaines cognitifs que les enfants nés à terme. Cependant, nos connaissances sur les habilités langagières précoces des enfants prématurés restent actuellement limitées. Le premier objectif de cette thèse était donc de spécifier différentes capacités de perception de la parole pendant les deux premières années, en référence à celles d'enfants nés à terme de même âge postnatal. Son second objectif était d'étudier si le degré de prématurité module les performances langagières des enfants prématurés. Cette thèse est organisée en trois parties expérimentales. La première a exploré la segmentation, c'est-à-dire la capacité à découper la parole en mots, qui est liée à l'acquisition du vocabulaire. Nos résultats ont établi qu'à 6 mois d'âge postnatal, les enfants prématurés ont des capacités de segmentation basiques (segmentation de mots monosyllabiques, Exp. 1), comme les enfants nés à terme de même âge postnatal (6 mois ; Nishibayashi, Goyet, & Nazzi, 2015) et corrigé (4 mois ; Exp. 2). Toutefois, nous avons aussi trouvé des différences avec les nés à terme. Si les enfants prématurés de 6 mois segmentent des syllabes intégrées dans des mots, comme précédemment trouvé pour les enfants nés à terme, l'effet de segmentation à des directions opposées chez les deux populations, suggérant différents mécanismes de traitement (Exp. 3). En outre, à 8 mois d'âge postnatal, nos résultats ne font pas apparaître de biais consonantique dans la reconnaissance des mots segmentés, comme chez les enfants nés à terme (Exp. 4). Néanmoins, des enfants bilingues prématurés et nés à terme qui ont le français comme langue dominante sont capables de segmenter des mots monosyllabiques à l'âge de 6 mois (Exp. 5). La deuxième partie a mesuré le comportement visuel d'enfants prématurés et nés à terme face à un visage parlant dans la langue maternelle (le français) et une langue étrangère (l'anglais). Nos résultats révèlent qu'à 8 mois, les enfants prématurés ont un comportement visuel différent de celui d'enfants nés à terme au même âge postnatal et corrigé. Alors que les enfants nés à terme ont un comportement visuel différent dans les deux langues, ce n'est pas le cas chez les enfants prématurés (Exp. 6). Ces comportements visuels différentiels sont les premiers éléments de caractérisation de la trajectoire développementale de la perception audiovisuelle des enfants prématurés. La troisième partie a porté sur le développement lexical. Nos résultats montrent que les enfants prématurés reconnaissent la forme des mots familiers à 11 mois d'âge postnatal (Exp.7), comme les enfants nés à terme (Hallé & de Boysson-Bardies, 1994). Concernant la production lexicale autour de l'âge de 24 mois postnatal (Exp. 8), nos résultats révèlent que les enfants prématurés ont un vocabulaire réduit par rapport aux enfants nés à terme de même âge postnatal, mais des niveaux similaires à ceux de même âge corrigé. Cependant, un pourcentage élevé des enfants prématurés étaient en dessous du centile 10 selon les normes de la population typique, ce qui pourrait constituer un indice d'identification de risque de délais langagiers. Pris ensemble, nos résultats offrent une vision plus détaillée et nuancée de l'acquisition langagière précoce des enfants nés à terme, et aident à mieux comprendre la contribution relative de l'input environnemental (i.e. exposition à input visuel et auditif non filtré) et la maturation neuronale à cette trajectoire développementale. / Prematurity is currently an important public health problem in the world that affects 1 in 10 babies worldwide every year. In France, preterm birth has steadily increased from 5.9% in 1995 to 7.3% in 2014. Research has demonstrated that prematurely born children are more susceptible to encounter some difficulties in language development and other cognitive domains than children born fullterm. To date, knowledge on early language abilities in preterm infants remains limited. The first goal of this doctoral research was to specify different speech perception abilities in the first two years of life in preterm infants, comparing their abilities to those of fullterm infants of the same postnatal age. The second goal was to investigate whether degree of prematurity modulates linguistic performance across preterm infants. This thesis is organized in three experimental parts. First, we explored word segmentation (the ability to extract word forms) from fluent speech, an ability that is related to lexical acquisition. Our findings showed that basic segmentation abilities are in place in monolingual preterm infants at 6 months of postnatal age (Exp. 1), since they segment monosyllabic words just like their postnatal (Nishibayashi, Goyet, & Nazzi, 2015) and corrected age (4-month-olds; Exp.2) fullterm peers. However, we also found differences with fullterms. While 6-month-old preterms segment embedded syllables as fullterms do (Nishibayashi et al., 2015), the direction of the effect is reversed, suggesting differential processing mechanisms (Exp. 3). Moreover, at 8 months postnatal age, we failed to find evidence for a consonant bias in recognition of segmented word forms (Exp. 4) as found for fullterms of the same age (Nishibayashi & Nazzi, 2016). Nevertheless, French-dominant bilingual populations were found to segment monosyllabic words in French at 6 months, whether being born pre- or full-term (Exp. 5). In the second part, using eye-tracking techniques, we measured preterm and fullterm infants scanning patterns of a talking face in the native (French) and a non-native (English) language. We found that preterm infants at 8 months postnatal age show different looking behavior than their fullterm counterparts matched on postnatal and maturational age. Compared to fullterm infants who showed different scanning pattern of a face speaking in the two languages, preterm infants showed similar scanning patterns for both languages (Exp. 6). These differential gaze patterns provide a first step to characterize the developmental course of audiovisual speech perception in preterm infants. The third part focused on lexical development. Our results show that preterm infants recognize familiar word forms at 11 months postnatal age (Exp. 7), hence at the same postnatal age as fullterm infants (Hallé & de Boysson-Bardies, 1994). With respect to word production at around 24 months of postnatal age (Exp. 8), we found that preterm infants have smaller vocabularies than fullterms of the same postnatal age, but as a group have similar levels as their fullterm, corrected age peers. However, more preterm infants were below the 10th percentile than expected based on (fullterm) norms, which might constitute an index for early identification of (preterm) infants at risk for linguistic delays. Taken together, our results help us build a more detailed and nuanced picture of early language acquisition in preterm infants, and better understand the relative contribution of environmental input (i.e. exposure to unfiltered auditory and visual input after preterm birth) and brain maturation on this developmental trajectory.

<p>In a prospective population-based study in Stockholm County, 1998-2000, the incidence of retinopathy of prematurity (ROP) was investigated and was found to be 36% in prematurely-born infants with a birth weight of ≤ 1500 grams. Compared to a study performed ten years ago, the overall incidence was unchanged, but was reduced in “mature” infants and increased in immature ones. The incidence of ROP was 25% in infants with a gestational age of ≤ 32 weeks at birth. The main risk factors for ROP were the gestational age at birth, followed by the birth weight. Current guidelines for ROP screening in Sweden were modified.</p><p>A 10-year follow-up study of the ophthalmological findings in prematurely-born children, previously included in a prospective population-based incidence study of ROP, was performed. The children were compared with full-term ones. </p><p>Prematurely-born children ran a four times higher risk of refractive errors than full-term ones. The cryotreated children had the highest risk, but those without ROP also had more refractive errors than the full-terms. Within the group of prematurely-born children, the cryotreated ones had the highest prevalence of myopia, astigmatism and anisometropia, but no difference was found regarding hypermetropia.</p><p>The visual acuity of prematurely-born children was poorer than that of the full-terms. The cryotreated children and those with neurological complications had the most marked reduction, but the children without ROP and neurological findings also had a poorer visual outcome than the full-terms. The prevalence of visual impairment was 1.8% among the prematurely-born children, and was due to ROP in half the cases and cerebral lesions in the others. </p><p>The cryotreated children had constricted peripheral visual fields compared to the untreated prematurely-born and full-term children. The central visual fields tended to be reduced in the prematurely-born children compared to the full-terms, but no difference was observed within the preterm group.</p>

In a prospective population-based study in Stockholm County, 1998-2000, the incidence of retinopathy of prematurity (ROP) was investigated and was found to be 36% in prematurely-born infants with a birth weight of ≤ 1500 grams. Compared to a study performed ten years ago, the overall incidence was unchanged, but was reduced in “mature” infants and increased in immature ones. The incidence of ROP was 25% in infants with a gestational age of ≤ 32 weeks at birth. The main risk factors for ROP were the gestational age at birth, followed by the birth weight. Current guidelines for ROP screening in Sweden were modified. A 10-year follow-up study of the ophthalmological findings in prematurely-born children, previously included in a prospective population-based incidence study of ROP, was performed. The children were compared with full-term ones. Prematurely-born children ran a four times higher risk of refractive errors than full-term ones. The cryotreated children had the highest risk, but those without ROP also had more refractive errors than the full-terms. Within the group of prematurely-born children, the cryotreated ones had the highest prevalence of myopia, astigmatism and anisometropia, but no difference was found regarding hypermetropia. The visual acuity of prematurely-born children was poorer than that of the full-terms. The cryotreated children and those with neurological complications had the most marked reduction, but the children without ROP and neurological findings also had a poorer visual outcome than the full-terms. The prevalence of visual impairment was 1.8% among the prematurely-born children, and was due to ROP in half the cases and cerebral lesions in the others. The cryotreated children had constricted peripheral visual fields compared to the untreated prematurely-born and full-term children. The central visual fields tended to be reduced in the prematurely-born children compared to the full-terms, but no difference was observed within the preterm group.

Objetivo: Determinar a influência da presença de cafeína no sangue de cordão umbilical na ocorrência de apneia. Métodos: Estudo de coorte prospectivo de recém-nascidos pretermos com peso de nascimento menor de 2.000 g. Os critérios de exclusão foram: mães que receberam opióides , ventilação mecânica durante os primeiros 4 dias de vida, malformação congênita cerebral e cardíaca maiores, asfixia perinatal, hemorragia peri-intraventricular severa, exsanguíneotransfusão antes do quarto dia de vida e uso de metilxantina antes da extubação. Os recém-nascidos foram divididos em: com e sem cafeína detectável no sangue de cordão umbilical e acompanhados nos primeiros quatro dias de vida para a ocorrência de apneia. Resultados: 87 com e 40 sem cafeína detectável no sangue de cordão umbilical foram estudados. A mediana da concentração de cafeína dos 87 pacientes com cafeína detectável no sangue de cordão umbilical foi 2,3 µg/ml (0,2-9,4 µg/ml). Não houve associação entre a ocorrência de apneia e a presença de cafeína no sangue de cordão umbilical. Recém-nascidos com cafeína detectável no cordão umbilical tiveram apnéia mais tarde (66.3 horas) do que aqueles com níveis indetectáveis (54.2 horas). Conclusão: a detecção de níveis de cafeína no sangue de cordão umbilical não diminuiu a ocorrência de apneia da prematuridade. Nós sugerimos que novos estudos com a administração de altas doses de cafeína para mães antes do parto prematuro, como estratégia para prevenir a apneia da prematuridade, devam ser realizados. / Objective: To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence. Methods: A prospective cohort study with preterm newborns with birth weight less than 2,000 g was undertaken. Exclusion criteria were: mothers that received opioids, mechanical ventilation during the first 4 days of life, cerebral and major cardiac malformations, perinatal asphyxia, severe periintraventricular hemorrhage, exchange transfusion before the fourth day of life, and those that received methylxantine prior to extubation. Neonates were divided in: with detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells. Results: 87 with and 40 without detectable caffeine in umbilical cord blood were studied. The median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 µg/ml (0.2-9.4 µg/ml). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had apnea later (66.3 ± 4.14 hours) than those with undetectable levels (54.2 ± 6.26 hours). Conclusion: The detected levels of caffeine in umbilical cord blood did not decrease the occurrence of apnea of prematurity. We suggest that further studies on administration of high dose of caffeine to mothers prior to a preterm delivery as a preventive measure for apnea of prematurity deserve to be conducted.

Objetivo: Determinar a influência da presença de cafeína no sangue de cordão umbilical na ocorrência de apneia. Métodos: Estudo de coorte prospectivo de recém-nascidos pretermos com peso de nascimento menor de 2.000 g. Os critérios de exclusão foram: mães que receberam opióides , ventilação mecânica durante os primeiros 4 dias de vida, malformação congênita cerebral e cardíaca maiores, asfixia perinatal, hemorragia peri-intraventricular severa, exsanguíneotransfusão antes do quarto dia de vida e uso de metilxantina antes da extubação. Os recém-nascidos foram divididos em: com e sem cafeína detectável no sangue de cordão umbilical e acompanhados nos primeiros quatro dias de vida para a ocorrência de apneia. Resultados: 87 com e 40 sem cafeína detectável no sangue de cordão umbilical foram estudados. A mediana da concentração de cafeína dos 87 pacientes com cafeína detectável no sangue de cordão umbilical foi 2,3 µg/ml (0,2-9,4 µg/ml). Não houve associação entre a ocorrência de apneia e a presença de cafeína no sangue de cordão umbilical. Recém-nascidos com cafeína detectável no cordão umbilical tiveram apnéia mais tarde (66.3 horas) do que aqueles com níveis indetectáveis (54.2 horas). Conclusão: a detecção de níveis de cafeína no sangue de cordão umbilical não diminuiu a ocorrência de apneia da prematuridade. Nós sugerimos que novos estudos com a administração de altas doses de cafeína para mães antes do parto prematuro, como estratégia para prevenir a apneia da prematuridade, devam ser realizados. / Objective: To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence. Methods: A prospective cohort study with preterm newborns with birth weight less than 2,000 g was undertaken. Exclusion criteria were: mothers that received opioids, mechanical ventilation during the first 4 days of life, cerebral and major cardiac malformations, perinatal asphyxia, severe periintraventricular hemorrhage, exchange transfusion before the fourth day of life, and those that received methylxantine prior to extubation. Neonates were divided in: with detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells. Results: 87 with and 40 without detectable caffeine in umbilical cord blood were studied. The median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 µg/ml (0.2-9.4 µg/ml). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had apnea later (66.3 ± 4.14 hours) than those with undetectable levels (54.2 ± 6.26 hours). Conclusion: The detected levels of caffeine in umbilical cord blood did not decrease the occurrence of apnea of prematurity. We suggest that further studies on administration of high dose of caffeine to mothers prior to a preterm delivery as a preventive measure for apnea of prematurity deserve to be conducted.

Objetivo: Determinar a influência da presença de cafeína no sangue de cordão umbilical na ocorrência de apneia. Métodos: Estudo de coorte prospectivo de recém-nascidos pretermos com peso de nascimento menor de 2.000 g. Os critérios de exclusão foram: mães que receberam opióides , ventilação mecânica durante os primeiros 4 dias de vida, malformação congênita cerebral e cardíaca maiores, asfixia perinatal, hemorragia peri-intraventricular severa, exsanguíneotransfusão antes do quarto dia de vida e uso de metilxantina antes da extubação. Os recém-nascidos foram divididos em: com e sem cafeína detectável no sangue de cordão umbilical e acompanhados nos primeiros quatro dias de vida para a ocorrência de apneia. Resultados: 87 com e 40 sem cafeína detectável no sangue de cordão umbilical foram estudados. A mediana da concentração de cafeína dos 87 pacientes com cafeína detectável no sangue de cordão umbilical foi 2,3 µg/ml (0,2-9,4 µg/ml). Não houve associação entre a ocorrência de apneia e a presença de cafeína no sangue de cordão umbilical. Recém-nascidos com cafeína detectável no cordão umbilical tiveram apnéia mais tarde (66.3 horas) do que aqueles com níveis indetectáveis (54.2 horas). Conclusão: a detecção de níveis de cafeína no sangue de cordão umbilical não diminuiu a ocorrência de apneia da prematuridade. Nós sugerimos que novos estudos com a administração de altas doses de cafeína para mães antes do parto prematuro, como estratégia para prevenir a apneia da prematuridade, devam ser realizados. / Objective: To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence. Methods: A prospective cohort study with preterm newborns with birth weight less than 2,000 g was undertaken. Exclusion criteria were: mothers that received opioids, mechanical ventilation during the first 4 days of life, cerebral and major cardiac malformations, perinatal asphyxia, severe periintraventricular hemorrhage, exchange transfusion before the fourth day of life, and those that received methylxantine prior to extubation. Neonates were divided in: with detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells. Results: 87 with and 40 without detectable caffeine in umbilical cord blood were studied. The median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 µg/ml (0.2-9.4 µg/ml). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had apnea later (66.3 ± 4.14 hours) than those with undetectable levels (54.2 ± 6.26 hours). Conclusion: The detected levels of caffeine in umbilical cord blood did not decrease the occurrence of apnea of prematurity. We suggest that further studies on administration of high dose of caffeine to mothers prior to a preterm delivery as a preventive measure for apnea of prematurity deserve to be conducted.

Notre recherche vise à éclairer les enjeux psychiques de la très grande prématurité chez la femme enceinte. Nous avons exploré les vécus de grossesse de 18 femmes enceintes à l’aide de l’I.R.M.A.G (Interview pour les Représentations Maternelles pendant la Grossesse) et du dessin. En questionnant les relations que les femmes enceintes entretiennent avec leur mère, ainsi que leur rapport à l’image (échographies, rêves) et aux perceptions, nous avons mis en évidence des liens mères-filles dépourvus de tendresse chez les femmes qui accouchent très prématurément et un surinvestissement du perceptif visant à les protéger de la dimension traumatique de la grossesse. Nous avons repéré la difficulté de ces femmes à investir le fœtus et à érotiser la grossesse. Notre recherche vise à mettre en relation, l'absence d'investissement de la présence du fœtus et l'expulsion de ce dernier avant terme. Les interrelations psyché-soma dans le processus de la prématurité sont au cœur de notre travail. / The aim of our research is to clarify the psychological stakes of extreme prematurity for the pregnant woman. We explored the factual pregnancy experience of 18 pregnant women with the aid of I.R.M.A.G (Interview for Maternal Representations during Pregnancy) and of drawings. By questioning the relationships that the pregnant women maintain with their mother, as well as their relation to pictures (ultrasound scan, dreams) and to perception, we highlighted mother-daughter bonds devoid of tenderness for women who give birth very prematurely and an overinvestment of perceptive aiming at protecting them from the traumatic dimension of the pregnancy. They do not manage to accept the foetus and to eroticise the pregnancy. The aim of our research is to demonstrate the relationship between the absence of accepting the presence of the foetus and the expulsion of it before term. The psyche-soma interrelationships in the prematurity process are the core of our work.

Magister Curationis - MCur / Parents undergo negative experiences that include parental anxiety, depression, and posttraumatic stress when their new-born babies are hospitalised in neonatal intensive care unit. During this stressful period, parents need assistance from staff in order to cope. A quantitative, descriptive survey design was used to describe parents’ perception of nursing support during their baby’s admission in neonatal intensive care units (NICU) at three selected private hospitals in the city of Cape Town in the Western Cape Province. A structured existing 21- item Likert type questionnaire, the Nurse-Parent Support Tool (NPST) was used to collect data from an all-inclusive sample of 85 parents with a response rate of 78.8% (n=67). The purpose of the questionnaire was to determine their perception of information giving and communication by nurses; emotionally supportive behaviours by nurses; care given support or instrumental support and to identify parents’ perception of esteem or appraisal support while in the NICU environment. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24. The findings of this study suggested that the overall mean score for parents’ perception of nursing support was high 4.6 (±0.5) out of a possible of 5. There was no significant difference in the overall mean perceived support score between the different facilities. No significant differences were found in terms of all the demographics characteristics with regard to perceptions of the support that was received, thus indicating that there was no relationship between the demographic variables and perception of support. The findings suggested that though high parental support was reported, the area of involving parents in the care of their babies i.e. letting them decide whether to stay or leave during procedures need improvement.

Os prematuros frequentemente necessitam de ajuda para iniciar a respiração, pois líquido amniótico residual e deficiência de surfactante podem impedir o estabelecimento da CRF. A necessidade de intubação e do uso de ventilação com pressão positiva está relacionada à chamada lesão pulmonar induzida pela ventilação. A intubação endotraqueal é uma ocorrência comum na unidade de terapia intensiva neonatal. A extubação acidental (EA) ou o deslocamento acidental do tubo endotraqueal é um evento inseguro e adverso. Um estudo norteamericano relatou que a EA é o quarto evento adverso mais comum na UTIN. Isso coloca o neonato em risco de morbidade significativa. As hipóteses iniciais para este estudo considerando as características locais do serviço, são que a taxa de extubação acidental deste serviço seria superior ou igual à encontrada na literatura e que as consequências da perda de volume pulmonar causada pela EA geraria uma necessidade de aumento de parâmetros ventilatórios, expondo esses pacientes a um maior risco de desenvolvimento de lesão pulmonar induzida pela ventilação mecânica. O presente estudo teve como objetivo estabelecer a densidade de extubação acidental para cada 100 pacientes-dia e os fatores de risco e as consequências associadas à extubação acidental em uma unidade de terapia intensiva neonatal. A coleta de dados ocorreu o período de fevereiro a dezembro de 2016. Foram elegíveis todos os recém-nascidos intubados com necessidade de ventilação mecânica invasiva e selecionados, para o estudo, os recém-nascidos em assistência ventilatória há pelo menos 12 horas. Nos 10 meses e meio de estudo (318 dias), observou-se uma média de 9,04 pacientes intubados por dia, sendo analisados 2875 pacientes-dia com via aérea artificial. Nos 318 dias de observação ocorreram 45 extubações acidentais, com taxa de EA de 1,57 para cada 100 dias intubação. Os recém-nascidos tinham em média 26,55±35,35 dias de vida na EA, mínimo de 3 dias e máximo de 182 dias. Na amostra estudada, todos os recém-nascidos necessitaram de reintubação após o evento de EA. As características clínicas foram semelhantes nos dois grupos. Assim, os dados apresentados evidenciam que os grupos estudados se apresentaram bastante homogêneos. Foram associados como fatores de risco para EA a utilização de material inadequado para a fixação da cânula orotraqueal (esparadrapo), a carência de pessoal para os cuidados diários (mais de 2 pacientes por funcionário), e mostrou-se ainda a grande importância dos alarmes de saturação sanguínea já que foram responsáveis por 60% diagnóstico da ocorrência do evento. A EA acarretou piora das condições respiratórias com necessidade de aumento do suporte ventilatório ( maior necessidade de oxigênio, pressão inspiratória e PEEP) e recuperação lenta às condições pré- acidente em média 5,7 dias. Concomitante com o aumento da necessidade de suporte respiratório houve maior ocorrência de hiperóxia após o acidente, levantando o temor de efeitos deletérios sinérgicos sobre o pulmão já anteriormente debilitado dos prematuros. É necessária a conscientização da administração e das equipes de profissionais da saúde das UTINs unidades, da enorme importância de se prevenir e diagnosticar precocemente a extubação acidental. / Premature infants often require help in initiating breathing, since residual amniotic fluid and surfactant deficiency may prevent the establishment of functional residual capacity. The need for intubation and the use of positive pressure ventilation is related with ventilator-induced lung injury. Endotracheal intubation is a common occurrence in the neonatal intensive care unit. Accidental extubation (AE) or accidental displacement of the endotracheal tube is an unsafe and adverse event. An American study has reported that EA is the fourth most common adverse event in the NICU. This puts the neonate at risk of significant morbidity. The initial hypotheses for this study considering the local characteristics of the service are that the rate of accidental extubation of this service would be higher than or equal to that found in the literature and that the consequences of loss of lung volume caused by the AE would generate a need for increased ventilatory parameters , exposing these patients to a higher risk of lung injury induced by mechanical ventilation. The present study aimed to establish the accidental extubation density for each 100 patients per day and the risk factors and consequences associated with accidental extubation in a neonatal intensive care unit. Data were collected from February to December 2016. All intubated newborns requiring invasive mechanical ventilation were eligible and the newborns in ventilatory assistance were selected for at least 12 hours for the study. In the 10 and a half months of study (318 days), an average of 9.04 intubated patients per day was observed, with 2875 day-patients with artificial airway being analyzed. In the 318 days of observation, there were 45 accidental extubations, with an AE rate of 1.57 for every 100 days of intubation. The newborns had a mean of 26.55±35.35 days of life in AE, a minimum of 3 days and a maximum of 182 days. In the studied sample, all newborns required reintubation after the AE event. As constitutional aspects were seem in the two groups. Thus, the presented data evidences that the studied groups are quite homogeneous. Risk factors for the use of materials for the fixation of the orotracheal waist (tape), a shortage of personnel for the longest care, and the greater importance of the alarms were included. of blood saturation that was responsible for 60% of the occurrence of the event. AE is one of the largest public health service companies in the world, inspiratory pressure and PEEP, and average recurring expenses an average of 5.7 days. Concomitant with the increased risk of respiratory accident for most cases following the occurrence of an accident, raising the risk of fire and synergy over the previous exercise already weakened of the premature. Immigration is an awareness of NICU management and staff of health professionals, which is important in preventing and early diagnosis of accidental extubation.