Paediatric intensive care nurses' and doctors' perceptions on nurse‐led protocol‐directed ventilation weaning and extubation

Tume, Lyvonne N; Scally, Alison; Carter, Bernie

doi:10.1111/nicc.12055

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…nurses management of insulin titration and weaning patients from mechanical ventilation. [5][6][7][8] A variety of studies evaluate and support nursing's role in providing improved nutritional support in critically ill children; specifically, time to first feeding and titrating enteral feeding to meet nutritional and caloric needs. [9][10][11] Although it is well-known that critically ill patients require nursing care that intervenes quickly to avert or respond to rapidly deteriorating clinical conditions, there are little data describing this core nursing activity.…”

Section: Facing Death: End Of Life Care and Decisionmakingmentioning

confidence: 99%

Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue

Tume

Coetzee

Dryden-Palmer

et al. 2015

Pediatric Critical Care Medicine

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Section: Facing Death: End Of Life Care and Decisionmakingmentioning

confidence: 99%

Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue

Tume

Coetzee

Dryden-Palmer

et al. 2015

Pediatric Critical Care Medicine

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“…There is no pediatric data supporting or refuting any weaning technique over the other. So, it remains to be determined if weaning should be led by physicians, nurses, or respiratory therapists (15)(16)(17). This means that the way children are weaned from the ventilator is heavily influenced by institutional preferences and personal experiences rather than scientific evidence (18).…”

Section: Technique Of Weaningmentioning

confidence: 99%

Clinical Challenges in Pediatric Ventilation Liberation: A Meta-Narrative Review

Dijk

Blokpoel

Abu‐Sultaneh

et al. 2022

Pediatric Critical Care Medicine

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OBJECTIVES: To map the evidence for ventilation liberation practices in pediatric respiratory failure using the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards. DATA SOURCES: CINAHL, MEDLINE, COCHRANE, and EMBASE. Trial registers included the following: ClinicalTrials.gov, European Union clinical trials register, International Standardized Randomized Controlled Trial Number register. STUDY SELECTION: Abstracts were screened followed by review of full text. Articles published in English language incorporating a heterogeneous population of both infants and older children were assessed. DATA EXTRACTION: None. DATA SYNTHESIS: Weaning can be considered as the process by which positive pressure is decreased and the patient becomes increasingly responsible for generating the energy necessary for effective gas exchange. With the growing use of noninvasive respiratory support, extubation can lie in the middle of the weaning process if some additional positive pressure is used after extubation, while for some extubation may constitute the end of weaning. Testing for extubation readiness is a key component of the weaning process as it allows the critical care practitioner to assess the capability and endurance of the patient’s respiratory system to resume unassisted ventilation. Spontaneous breathing trials (SBTs) are often seen as extubation readiness testing (ERT), but the SBT is used to determine if the patient can maintain adequate spontaneous ventilation with minimal ventilatory support, whereas ERT implies the patient is ready for extubation. CONCLUSIONS: Current literature suggests using a structured approach that includes a daily assessment of patient’s readiness to extubate may reduce total ventilation time. Increasing evidence indicates that such daily assessments needs to include SBTs without added pressure support. Measures of elevated load as well as measures of impaired respiratory muscle capacity are independently associated with extubation failure in children, indicating that these should also be assessed as part of ERT.

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“…In some countries in Europe and North America, there has been a tendency to understand the role of the multidisciplinary team in detecting “weanable” patients and in conducting the protocol. ( 17 - 19 )…”

Section: Weaning Management - a Multiprofessional Issuementioning

confidence: 99%

Pediatric ventilation weaning

Lourenção

Carvalho

2020

Revista Brasileira De Terapia Intensiva

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Paediatric intensive care nurses' and doctors' perceptions on nurse‐led protocol‐directed ventilation weaning and extubation

Abstract: This paper highlights the complexities involved in instituting and establishing a nurse-led, protocol-driven ventilation weaning process within a PICU. Further, in depth research is required to examine both PICU nurses and doctors attitudes to NLVW both in the UK and across Europe.

Cited by 10 publications

References 24 publications

Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue

Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue

Clinical Challenges in Pediatric Ventilation Liberation: A Meta-Narrative Review

Pediatric ventilation weaning

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