About this episode

The episode discusses optimizing time to extubation in the PICU, focusing on a nurse-led intervention for infants with bronchiolitis.

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Rebecca Mitting, MD, MRCPCH, consultant pediatric intensivist and clinical lead for the PICU at Imperial College Healthcare NHS Trust in London. They discuss Dr. Mitting’s article, “Sedation and Ventilator Weaning Bundle and Time to Extubation in Infants With Bronchiolitis: Secondary Analysis of the Sedation AND Weaning in Children (SANDWICH) Trial,” published in the April 2025 issue of Pediatric Critical Care Medicine. The SANDWICH trial, conducted in the United Kingdom, evaluated a nurse-led intervention of sedation scoring, goal-based sedation weaning, and protocolized extubation readiness testing. While the original trial demonstrated only a modest reduction in ventilation duration, Dr. Mitting’s subgroup analysis of infants with bronchiolitis found a reduction of median time to successful extubation by approximately 16 to 17 hours. Dr. Mitting highlights the importance of these findings during the winter season when bronchiolitis drives up PICU occupancy and strain. The critical trade-off between minimizing ventilator days and avoiding extubation failure…

People in this episode

Host: Elizabeth H. Mack, MD, MS, FCCM

Guests: Rebecca Mitting, MD, MRCPCH, Rebecca Mitting

Topics covered

• extubation
• PICU
• bronchiolitis
• sedation
• ventilator weaning
• pediatric care

Keywords

• extubation timing
• PICU occupancy
• bronchiolitis treatment
• sedation protocols
• ventilator duration
• COVID-19 impact
• pediatric intensivist

Mentioned in this episode

Organizations: Society of Critical Care Medicine, Imperial College Healthcare NHS Trust, Pediatric Critical Care Medicine

Books & works: Sedation and Ventilator Weaning Bundle and Time to Extubation in Infants With Bronchiolitis: Secondary Analysis of the Sedation AND Weaning in Children (SANDWICH) Trial

Places: London

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