Weaning from noninvasive ventilatory support in infants with severe bronchiolitis: An observational study

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2023-05, Vol.30 (4), p.201-205
• Main Authors: Cassibba, J., Freycon, C., Doutau, J., Pin, I., Bellier, A., Fauroux, B., Mortamet, G.
• Format: Article
• Language: English
• Subjects: Acute respiratory failure; Bronchiolitis - therapy; Cannula; Child; Continuous Positive Airway Pressure; Critically ill children; Humans; Infant; Mechanical ventilation; Noninvasive Ventilation; Oxygen Inhalation Therapy; Respiration, Artificial; Weaning
• ISSN: 0929-693X; 1769-664X
• DOI: 10.1016/j.arcped.2023.03.003

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. 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. 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