Julie Cassibba, Marie Chevallier, Aurélie Alexandre, Alice Fumagalli, Brigitte Fauroux, Guillaume Mortamet
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Impact of a nurse-driven noninvasive respiratory support discontinuation protocol in infants with severe bronchiolitis.
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.
期刊介绍：
Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics.
Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues.
All manuscripts submitted to the journal are subjected to peer review by international experts, and must:
Be written in excellent English, clear and easy to understand, precise and concise;
Bring new, interesting, valid information - and improve clinical care or guide future research;
Be solely the work of the author(s) stated;
Not have been previously published elsewhere and not be under consideration by another journal;
Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed.
Under no circumstances does the journal guarantee publication before the editorial board makes its final decision.
Archives de Pédiatrie is the official publication of the French Society of Pediatrics.
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