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Research ArticleOriginal Research

Implementing a Weaning Protocol for Noninvasive Respiratory Support in Neonates Decreases Overuse and
Length of Stay

David N Matlock, Sarah M Perez, Heather A Borchert, Betty L Proffitt, Sara E Peeples, Angela L Chandler, Sherry E Courtney, Shasha Bai and Ashley S Ross
Respiratory Care April 2021, 66 (4) 644-651; DOI: https://doi.org/10.4187/respcare.07985
David N Matlock
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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  • For correspondence: [email protected]
Sarah M Perez
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Heather A Borchert
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Betty L Proffitt
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Sara E Peeples
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Angela L Chandler
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Sherry E Courtney
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Shasha Bai
Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio.
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Ashley S Ross
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Abstract

BACKGROUND: As part of efforts to decrease length of hospital stay, a protocol for weaning noninvasive respiratory support was implemented using quality improvement methodology. The objective of this study was to determine whether protocol implementation decreased the time to wean to no respiratory support by 24 h (30% reduction) over 3 months in preterm infants 30–34 weeks gestational age.

METHODS: A quality improvement project was conducted with the following outcome measures: primary outcome measured was hours to wean; secondary outcomes included duration of respiratory support, length of stay, and postmenstrual age at feeding milestones; and balance measures were duration of oxygen exposure and growth velocity.

RESULTS: Data from 89 subjects were included. Following implementation, decreases were seen in time to wean (40% reduction, P < .001), length of stay (25% reduction, P = .02), and growth velocity (21% reduction, P = .02).

CONCLUSIONS: Implementing a weaning protocol decreases duration of support and length of stay in infants 30–34 weeks gestational age. Weaning respiratory support more quickly may decrease growth velocity.

  • quality improvement
  • standardization
  • noninvasive respiratory support
  • continuous positive airway pressure
  • high-flow nasal cannula

Footnotes

  • Correspondence: David N Matlock MD, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 512-5B, Little Rock, AR 72205. E-mail: DMatlock{at}uams.edu
  • Dr Matlock presented a version of this paper at the 2017 annual meeting for the Vermont Oxford Network, held in Chicago, IL; by Dr Matlock at the 2017 annual meeting for Southern Society for Pediatric Research, held in New Orleans, LA; by Dr Matlock at the 2018 annual meeting for Society for Pediatric Research, held in Toronto, Ontario; and by Dr Ross at the 2018 annual meeting for Children’s Hospitals Neonatal Consortium, held in Columbus, OH.

  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (4)
Respiratory Care
Vol. 66, Issue 4
1 Apr 2021
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Implementing a Weaning Protocol for Noninvasive Respiratory Support in Neonates Decreases Overuse and
Length of Stay
David N Matlock, Sarah M Perez, Heather A Borchert, Betty L Proffitt, Sara E Peeples, Angela L Chandler, Sherry E Courtney, Shasha Bai, Ashley S Ross
Respiratory Care Apr 2021, 66 (4) 644-651; DOI: 10.4187/respcare.07985

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Implementing a Weaning Protocol for Noninvasive Respiratory Support in Neonates Decreases Overuse and
Length of Stay
David N Matlock, Sarah M Perez, Heather A Borchert, Betty L Proffitt, Sara E Peeples, Angela L Chandler, Sherry E Courtney, Shasha Bai, Ashley S Ross
Respiratory Care Apr 2021, 66 (4) 644-651; DOI: 10.4187/respcare.07985
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Keywords

  • quality improvement
  • standardization
  • noninvasive respiratory support
  • continuous positive airway pressure
  • High-flow nasal cannula

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