Weaning 02 in the NICU

Double-Helix, BSN, RN · Apr 20, 2012

This question is probably better suited for the NICU forum.

The answer is that it depends on the child's condition, your facility policies, and the preference of the physician. In most cases it's expected that you may not be able to wean oxygen as quickly as decreasing every 15 minutes, and it's very possible you may have to increase the O2 slightly or leave the child on O2 for a longer period when you're trying to wean.

Are you talking about weaning from a ventilator or weaning from a nasal cannula? You'll have different responsibilities with each. Weaning from a ventilator often requires specific orders for changing the settings, and you'll do this in conjunction with the respiratory therapist. You will likely be monitoring blood gases in the process of weaning. Weaning from a nasal cannula can be done more simply and independently.

It also depends on the reason the child is on the oxygen. If there is no clinical reason why they should require oxygen, yet they continue to desat during weaning, I would call the doctor sooner because more work up is needed. If the patient still has some crackles from pneumonia, it makes more sense that they would need supplemental O2 and I won't get worked up if I can't wean them right away, or if they have some desats with feeds/exertion.

To make it easier for you, it's a good idea just to ask the attending physician what they think. When they write to wean, ask if they want to be notified if you cannot wean at all, or at what point they want to be contacted. Also check your policy and procedure manual to see if you have any specific regulations related to O2 weaning.