Impact of a nurse-driven noninvasive respiratory support discontinuation protocol in infants with severe bronchiolitis - 28/01/25
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.
Le texte complet de cet article est disponible en PDF.Keywords : Infants, Noninvasive ventilation, Nurse-driven, Weaning, Discontinuation, Paediatric intensive care units
Plan
Vol 32 - N° 1
P. 18-23 - janvier 2025 Retour au numéro
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