Weaning from noninvasive ventilatory support in infants with severe bronchiolitis : An observational study
Copyright © 2023 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved..
BACKGROUND: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized in a pediatric intensive care unit over a winter season.
METHODS: A retrospective observational study was conducted in a pediatric intensive care unit in a tertiary center. Infants hospitalized for severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV), or high-flow nasal cannula (HFNC) was analyzed.
RESULTS: Data from 95 infants (median age, 47 days) were analyzed. On admission, 26 (27%), 46 (49%), and 23 (24%) infants were supported with CPAP, NIV, and HFNC, respectively. Weaning failed in one (4%), nine (20%), and one (4%) infants while supported with CPAP, NIV, or HFNC, respectively (p = 0.1). In infants supported with CPAP, CPAP was stopped directly in five patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 h, [IQR: 0-26]) than for CPAP (24 h, [14-40]) and NIV (28 h, [19-49]) (p < 0.01).
CONCLUSIONS: The weaning phase corresponds to a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a "step-down" strategy may lead to an increase in the duration of weaning.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie - 30(2023), 4 vom: 17. Mai, Seite 201-205 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cassibba, J [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory failure |
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| Anmerkungen: |
Date Completed 01.05.2023 Date Revised 01.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.arcped.2023.03.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354958747 |
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| 245 | 1 | 0 | |a Weaning from noninvasive ventilatory support in infants with severe bronchiolitis |b An observational study |
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| 500 | |a Date Revised 01.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a BACKGROUND: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized in a pediatric intensive care unit over a winter season | ||
| 520 | |a METHODS: A retrospective observational study was conducted in a pediatric intensive care unit in a tertiary center. Infants hospitalized for severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV), or high-flow nasal cannula (HFNC) was analyzed | ||
| 520 | |a RESULTS: Data from 95 infants (median age, 47 days) were analyzed. On admission, 26 (27%), 46 (49%), and 23 (24%) infants were supported with CPAP, NIV, and HFNC, respectively. Weaning failed in one (4%), nine (20%), and one (4%) infants while supported with CPAP, NIV, or HFNC, respectively (p = 0.1). In infants supported with CPAP, CPAP was stopped directly in five patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 h, [IQR: 0-26]) than for CPAP (24 h, [14-40]) and NIV (28 h, [19-49]) (p < 0.01) | ||
| 520 | |a CONCLUSIONS: The weaning phase corresponds to a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a "step-down" strategy may lead to an increase in the duration of weaning | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute respiratory failure | |
| 650 | 4 | |a Critically ill children | |
| 650 | 4 | |a Infant | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Weaning | |
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| 700 | 1 | |a Doutau, J |e verfasserin |4 aut | |
| 700 | 1 | |a Pin, I |e verfasserin |4 aut | |
| 700 | 1 | |a Bellier, A |e verfasserin |4 aut | |
| 700 | 1 | |a Fauroux, B |e verfasserin |4 aut | |
| 700 | 1 | |a Mortamet, G |e verfasserin |4 aut | |
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