护士主导的无创呼吸支持停用方案对重症支气管炎婴儿的影响。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2024-11-20 DOI:10.1016/j.arcped.2024.08.006

Julie Cassibba, Marie Chevallier, Aurélie Alexandre, Alice Fumagalli, Brigitte Fauroux, Guillaume Mortamet

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引用次数: 0

摘要

背景：对儿科重症监护室收治的支气管炎婴儿进行护士驱动的呼吸支持中止方案评估：对儿科重症监护室收治的支气管炎婴儿停止呼吸支持的护士驱动方案进行评估：方法：在一家三级医疗中心进行一项回顾性单中心研究，采用前后对比设计：共纳入 187 名婴儿（95 名采用标准方案，92 名采用护士驱动方案）。两个阶段的断奶失败率没有差异（11 (12 %) 对 14 (15 %)，p = 0.46）。在护士驱动方案期间，通气支持的中断时间较晚（44 小时（IQR 29-67）对 33 小时（IQR 19-46），p = 0.001），但断气过程持续时间比方案实施前短（24 小时（IQR 0-60 ）对 39 小时（IQR 18-64），p = 0.01）。方案实施前后的总通气时间（不包括使用 BiPAP 的时间）相似（53 小时（IQR 37-81 小时）对 55 小时（IQR 28-81 小时），p = 0.46）。两个阶段的 PICU 和住院时间没有差异：结论：在使用无创呼吸支持的支气管炎患者中，护士主导的停用管理（而非医生主导）与较晚停用呼吸支持有关，而断奶过程持续时间比实施方案前更短。

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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.

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

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.