Mechanical ventilation is a lifesaving procedure for critically ill newborn infants but is associated with signi cant morbidity.
• Attempts to discontinue invasive mechanical ventilation should be tried as soon as possible.
• The use of weaning protocols, including systematic spontaneous breathing trials, has the potential to reduce the duration of mechanical ventilation.
• Future research should focus in better identifying the best predictive tools for a successful weaning, as well as the synergistic effect of adjunctive treatments in reducing the risk of extubation failure.