title: Weaning from mechanical ventilation: patterns in young children recovering from acute hypoxemic respiratory failure.
abstract: OBJECTIVE
  The purpose of the study was to describe the patterns of weaning from mechanical ventilation in young children recovering from acute hypoxemic respiratory failure.
  
  
  METHODS
  Decision-making rules on progressive weaning were developed and applied to existing data on 82 patients 2 weeks to 6 years old in the Pediatric Acute Respiratory Distress Syndrome Data Set.
  
  
  RESULTS
  Three patterns of weaning progress were detected: sprint, consistent, and inconsistent. Length of ventilation and weaning progressively increased from the sprint, to the consistent, to the inconsistent subset. Patients in the inconsistent subset were most likely to have a systemic (sepsis or shock) trigger of acute respiratory distress syndrome and to be rated as having at least moderate disability at discharge. Hypothesis-generating univariate and then multivariate logistic regression analyses indicated that patients who experienced more days of mechanical ventilation before the start of weaning and who had a higher oxygenation index during the weaning process were most likely to have an inconsistent pattern of weaning.
  
  
  CONCLUSIONS
  Patterns of weaning are discernible in a population of young children and indicate a subset at risk for inconsistent weaning. Knowing the patterns of weaning may help clinicians anticipate, perhaps plot, and then modulate a patient's weaning trajectory.
authors.affiliation: Children's Hospital, Boston, Mass., USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Curley
authors.forename: J C
authors.initials: JC
authors.lastname: Fackler
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D015400:Clinical Nursing Research; D003289:Convalescence; D003422:Critical Care; D003661:Decision Support Techniques; D006233:Persons with Disabilities; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009730:Nursing Assessment; D010363:Pattern Recognition, Automated; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods* / Q000451:nursing*