AI Article Synopsis
- The study aimed to assess a nurse-driven protocol for ending respiratory support in infants with bronchiolitis in pediatric intensive care units.
- A total of 187 infants were analyzed, revealing no significant difference in weaning failure rates, but the nurse-driven approach resulted in later discontinuation of ventilatory support and a shorter weaning duration compared to the previous method.
- Overall, while the timing of discontinuation changed, the total ventilation time and lengths of stay in the PICU and hospital remained similar between the two approaches.
Article Abstract
Background: To evaluate a nurse-driven respiratory support discontinuation protocol in infants with bronchiolitis admitted in paediatric intensive care units.
Methods: A retrospective single-center study with pre-versus-post comparative design in a tertiary center.
Results: In total, 187 infants (95 with standard and 92 with nurse-driven protocols) were included. There was no difference in terms of weaning failure between the two periods (11 (12 %) versus 14 (15 %), p = 0.46). During the nurse-driven protocol period, discontinuation of the ventilatory support was performed later (at 44 hrs (IQR 29-67) versus 33 hrs (IQR 19-46), p = 0.001), but the weaning process duration was shorter than before protocol implementation (24 h (IQR 0-60) versus 39 (IQR 18-64), p = 0.01). The total duration of ventilation (excluding time on BiPAP) was similar before and after protocol (53 (IQR 37-81) versus 55 h (IQR 28-81), p = 0.46). The PICU and hospital lengths of stay did not differ between the two periods.
Conclusions: In patients with bronchiolitis supported by noninvasive respiratory support, the nurse-driven discontinuation management - as opposed to physician-driven - was associated with a later discontinuation of the ventilatory support, while the weaning process duration was shorter than before protocol implementation.
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| http://dx.doi.org/10.1016/j.arcped.2024.08.006 | DOI Listing |
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