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

Abstract

To reach a consensus on the definition and modalities of weaning from noninvasive ventilation in acute settings. A modified Delphi survey using closed and open-ended questions. 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. Twenty-five international experts from 10 countries. 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. 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.