ArticleJAMA otolaryngology-- head & neck surgery2015
Systemwide change of sedation wean protocol following pediatric laryngotracheal reconstruction.
Article in JAMA otolaryngology-- head & neck surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Guidelines for the Management of Adult Subglottic and Tracheal Stenosis From the Korean Bronchoesophagological Society.Clinical and experimental otorhinolaryngology · 2026Guideline
- [Clinical practice guidelines for pediatric open laryngotracheoplasty（2026）].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2026Guideline
- Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis.Clinical and experimental pediatrics · 2025Article
- Exposure-Based Methadone and Lorazepam Weaning Protocol Reduces Wean Length in Children.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- Reevaluating a Standardized Sedation Weaning Protocol for Pediatric Laryngotracheal Reconstruction for Continuous Quality Improvement.JAMA otolaryngology-- head & neck surgery · 2019Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
importancePediatric laryngotracheal reconstruction (LTR) remains the standard surgical technique for expanding a stenotic airway and necessitates a multidisciplinary team. Sedation wean following LTR is a critical component of perioperative care. We identified variation and communications deficiencies with our sedation wean practice and describe our experience implementing a standardized sedation wean protocol.
objectiveTo standardize and decrease length of sedation wean in pediatric patients undergoing LTR. DESIGN, SETTING, AND
participantsUsing Institute for Healthcare Improvement (IHI) methodology, we implemented systemwide change at a tertiary care center with the goal of improving care based on best practice guidelines. We created a standardized electronic sedation wean communication document and retrospectively examined our experience in 29 consecutive patients who underwent LTR before (n = 16, prewean group) and after (n = 13, postwean group) wean document implementation.
interventionsImplementation of a standardized sedation protocol. MAIN OUTCOMES AND MEASURES: Presence of sedation wean document in the electronic medical record, length of sedation wean, and need for continued wean after discharge.
resultsThe sedation wean document was used in 92.3% patients in the postwean group. With the new process, the mean (SD) length of sedation wean was reduced from 16.19 (11.56) days in the prewean group to 8.92 (3.37) days in the postwean group (P = .045). Fewer patients in the postwean group required continued wean after discharge (81.3% vs 33.3%; P = .02). CONCLUSIONS AND RELEVANCE: We implemented a systemwide process change with the goal of improving care based on best practice guidelines, which significantly decreased the time required for sedation wean following LTR. Our methodological approach may have implications for other heterogeneous patient populations requiring a sedation wean.
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Registered trials
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