Weaning from noninvasive respiratory support in children in acute settings: Expert consensus statement using modified...

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Pulmonology

Background:

• Noninvasive ventilation (NIV) is crucial in acute settings.
• Standardized definitions and modalities for weaning from NIV are lacking.
• Lack of consensus hinders optimal patient management and clinical practice.

Purpose of the Study:

• To establish expert consensus on the definition and modalities of weaning from NIV in acute care.
• To define weaning failure, criteria for initiating weaning, and appropriate weaning methods.

Main Methods:

• A modified Delphi survey was employed, utilizing closed and open-ended questions.
• Three rounds of electronic surveys were conducted with 25 international experts from 10 countries.
• The survey focused on defining weaning, weaning failure, initiation criteria, and weaning modalities.

Main Results:

• Expert consensus was achieved for 19 out of 35 statements regarding NIV weaning (9 strong, 10 weak agreement).
• No negative consensus was identified among the participating experts.
• The survey generated significant agreement on key aspects of NIV weaning protocols.

Conclusions:

• The study successfully established clinical practice statements on NIV weaning in acute settings.
• These statements address critical aspects including the definition of weaning, weaning failure, and initiation criteria.
• The findings aim to standardize and improve the management of patients undergoing NIV weaning.