Non-invasive Ventilation in Pediatric Bronchiolitis: Variables Related to Weaning Readiness and Efficacy
Bibliographic record
Abstract
Background: There is a lack of evidence related to weaning non-invasive ventilation in bronchiolitis. The purpose of this study was to identify variables related to NIV weaning readiness, efficacy, and approach in bronchiolitis. Methods: Retrospective cohort study of 74 children, less than two years of age with bronchiolitis, requiring NIV and admitted to a pediatric intensive care unit (PICU) from 2022 to 2023. Demographic variables, clinical metrics, NIV mode, and weaning metrics were collected. Results: Mean total duration of NIV therapy was 40 hours with weans lasting 13 hours. Duration for children on CPAP alone was shorter (26 hours) than for children on combination of BiPAP and CPAP (45 hours, 95% CI 4.258 to 33.742, P = 0.0123). Wean times were also shorter for children on CPAP alone (mean 5 hours) than children on BiPAP and CPAP (mean 16 hours) (95% CI 1.899 to 20.101, P = 0.0185). Patients were more likely to have a ‘complex wean,’ defined as escalation and de-escalation between multiple settings, with BiPAP (44.6%) than with CPAP (18.8 %). RR at first wean was a significant predictor of NIV weaning duration (p=0.007). Conclusion: There is a need for NIV weaning guidelines. RR may be an important predictor of NIV weaning readiness and efficacy. A ‘complex wean’ may be a potential outcome variable for weaning NIV in children with bronchiolitis. This study may be used to inform future research and guidelines for weaning NIV in children with bronchiolitis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".