SLPCohortJournal of pediatric rehabilitation medicine2024

Post-acute day and night non-invasive respiratory intervention use and outcome: A brief report.

Jane E O'Brien, Helene M Dumas, M Laurette Hughes and 2 others

PMID 38578906

WHAT IT FOUND

In 38 children on non-invasive breathing support, most needed the same level during post-acute care.

Daytime support was generally less intensive than nighttime; 7 reduced daytime support and 9 reduced nighttime support.

Key findings

01Most children had no change in daytime support (27 of 38), and at night (25).

02At admission, low-flow oxygen was the most common daytime support (23, 44%), and positive airway pressure was the most common nighttime support (20, 53%).

03Seven children reduced daytime support and nine children reduced nighttime support.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

Only 38 children were studied at one post-acute hospital, and they ranged widely in age and diagnosis, so the results may not apply to other settings or patients. The report looked only at initial admissions, so later readmissions or transfers could change the final respiratory support level. Children needing tracheostomy support were excluded, so the results do not describe that more invasive respiratory population. Some outcomes were limited by equipment and interface choices, such as no home high-flow oxygen and weight or mask barriers for CPAP or BiPAP. The study describes what happened to respiratory support. It did not test a weaning protocol or compare treatments, so it cannot show that any intervention caused change.

The easy way to misread this

Do not read the reductions in non-invasive breathing support as proof that a weaning method works. This was a small single-site descriptive report with no comparison group, and most children had no change from admission to discharge.

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