Spontaneous breathing trial reduces mechanical ventilation weaning when compared with SmartCare™ ventilation
© Taniguchi et al; licensee BioMed Central Ltd. 2013
Published: 19 June 2013
Mechanical ventilation (MV) weaning is commonly performed using a spontaneous breathing trial (SBT) with pressure support ventilation after a daily weaning screen . Recently there has been increased interest in automatic weaning trials, using respiratory rate, tidal volume and ETCO2 monitoring during SBT [1, 2]. So far there is no clinical evidence comparing an automatic weaning trial with SBT. Our study's objective was to compare MV and weaning times between Automatic Weaning Ventilation System (SmartCare™/PS) and SBT groups.
A randomized, controlled study was performed in a general ICU. We enrolled adult patients who were ventilated for more than 24 hours. Patients were randomized either to the control or SmartCare™ group. All patients were ventilated with a Drager EvitaXL (Drager Medical, Lubeck, Germany) ventilator with SmartCare™/PS software version 1.1. The control group consisted of a daily weaning screen and SBT with pressure support ventilation; if patients tolerated SBT they were extubated. SmartCare™ group patients were also submitted to a daily weaning screen, after which they were ventilated with the SmartCare™/PS mode. We evaluated the MV and weaning time, maximum inspiratory pressure, maximum expiratory pressure, vital capacity, respiratory frequency to tidal volume ratio (f/Vt), use of noninvasive ventilation (NIV) post extubation, and re-intubation rate.
Characteristics of patients between SmartCare™ and control groups
60 (46 to 77)
65 (57 to 81)
45 (40 to 53)
40 (36 to 50)
40 (30 to 59)
40 (21 to 44)
1,200 (900 to 1,850)
1,000 (500 to 1,600)
35 (24 to 55)
40 (26 to 68)
4 (2 to 6)
3 (2 to 7)
110 (80 to 120)
60 (50 to 80)
Use of NIV post extubation
SBT showed a reduction in weaning time when compared with the SmartCare™/PS group, although there was no impact on total MV time and reintubation rate.
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