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

Abstract

Objective: To reach a consensus on the definition and modalities of weaning from noninvasive ventilation in acute settings.

Design: A modified Delphi survey using closed and open-ended questions.

Setting: Three rounds of consensus determination were sent via electronic mail survey to 33 experts. The survey questionnaire had four sections: definition of weaning, definition of weaning failure, criteria to initiate weaning, and modalities of weaning. Questions where agreement had been reached on round 1 were no longer part of the survey in rounds 2 and 3.

Subjects: Twenty-five international experts from 10 countries.

Measurement and main results: Overall, this survey generated positive consensus from experts for 19/35 statements (9 with strong agreement and 10 with weak agreement) about weaning from noninvasive respiratory support. No negative consensus could be identified.

Conclusion: The clinical practice statements issued address important aspects of definition of weaning, definition of weaning failure, criteria to initiate weaning, and modalities of weaning in acute settings.

Keywords: discontinuation; noninvasive ventilation; pediatric intensive care unit; weaning.