{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:13:23Z","timestamp":1771046003573,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T00:00:00Z","timestamp":1461542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Children with chronic respiratory failure and upper airway disorders may require tracheostomy placement and long\u2010term mechanical ventilation, yet many improve to permit ventilator weaning and decannulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>As a quality improvement project, we conducted a chart review of patients followed by our Ventilator Care Program who underwent evaluation for weaning nocturnal ventilation (NV) and\/or decannulation from 2007\u20132014. We collected patient demographics and characterized location, monitoring techniques, and outcomes for patients undergoing weaning NV or decannulation. We attempted to implement end tidal carbon dioxide (ETCO<jats:sub>2<\/jats:sub>) monitoring and used linear regression to compare ETCO<jats:sub>2<\/jats:sub> with morning pCO<jats:sub>2<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Weaning NV was successful in 20\/21 patients. Decannulation was successful in 18\/21 attempts. Once implemented, ETCO<jats:sub>2<\/jats:sub> was piloted and successfully performed in 12 attempts (29%). Blood testing was performed in 24\/42 trials (57%). When measured, the final ETCO<jats:sub>2<\/jats:sub> result partially correlated with morning pCO<jats:sub>2<\/jats:sub> (R<jats:sup>2<\/jats:sup>\u2009=\u20090.53, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.02). Neither blood testing nor ETCO<jats:sub>2<\/jats:sub> was performed for the four patients with unsuccessful attempts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inpatient observation for weaning NV and decannulation is safe and, in most cases, successful. With close observation, weaning NV at home may also be safe. Blood testing and ETCO<jats:sub>2<\/jats:sub> monitoring were frequently utilized, but rarely affected decision\u2010making since signs of respiratory distress were observed clinically prior to testing. ETCO<jats:sub>2<\/jats:sub> monitoring may provide reassurance without venipuncture. With our experience, we propose an algorithm for weaning NV and decannulation. <jats:bold>Pediatr Pulmonol. 2016;51:825\u2013829<\/jats:bold>. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.23436","type":"journal-article","created":{"date-parts":[[2016,4,26]],"date-time":"2016-04-26T00:22:50Z","timestamp":1461630170000},"page":"825-829","source":"Crossref","is-referenced-by-count":29,"title":["Weaning nocturnal ventilation and decannulation in a pediatric ventilator care program"],"prefix":"10.1002","volume":"51","author":[{"given":"Deborah R.","family":"Liptzin","sequence":"first","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Pulmonary Medicine University of Colorado School of Medicine Aurora Colorado"},{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth A.","family":"Connell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Pulmonary Medicine University of Colorado School of Medicine Aurora Colorado"},{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Marable","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Pulmonary Medicine University of Colorado School of Medicine Aurora Colorado"},{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Pulmonary Medicine University of Colorado School of Medicine Aurora Colorado"},{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi","family":"Thrasher","sequence":"additional","affiliation":[{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Pulmonary Medicine University of Colorado School of Medicine Aurora Colorado"},{"name":"Breathing Institute Children's Hospital Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922812465943"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2990"},{"key":"e_1_2_7_4_1","first-page":"365","article-title":"Weaning children from mechanical ventilation in a post\u2010acute care 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