Day vs. night non-invasive respiratory intervention during post-acute
care hospitalization
Abstract
Objective To compare daytime and nighttime use and outcome for
non-invasive respiratory intervention (NIRI) during initial admission to
a pediatric post-acute care hospital (PACH). Method Retrospective
examination of initial PACH admissions (October 2018 through September
2020) for infants and children requiring NIRI during the day and night.
Measures included: 1) Demographics (e.g. age, diagnostic group); 2)
Daytime and nighttime NIRI type (supplemental oxygen therapy via low
flow nasal cannula or positive airway pressure (PAP) via high-flow nasal
cannula, continuous positive airway pressure (CPAP), or biphasic
positive airway pressure (BiPAP) at admission and discharge; and 3)
Outcome (reduction, increase, or no change) in NIRI support for daytime
and nighttime from admission to discharge. Results Thirty-eight infants
and children (mean age=3.64 years; premature infants, n=20, other
diagnoses, n=18) were included. For the total sample (n=38), daytime vs.
nighttime NIRI type was significantly different (p<.001). At
both admission and discharge, supplemental oxygen was the most common
NIRI during the day, while PAP was most common at night. From admission
to discharge, 7 (18%) children had a positive change (reduced NIRI)
during the day, while 9 (24%) had a positive change at night. At
discharge, 11/38 (29%) children required no daytime NIRI, while 4/38
(11%) required no day or night NIRI. Conclusion NIRI type differs
between day and night at PACH admission and discharge. Reductions in
NIRI were achieved during the day and at night from PACH admission to
discharge for premature infants and for children with congenital or
neurological diagnoses.