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Updated: Jun 6, 2025

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
Impact of a nurse-driven noninvasive respiratory support discontinuation protocol in infants with severe
Julie Cassibba1, Marie Chevallier2, Aurélie Alexandre3
1Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France.
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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