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SmartCare is faster than paper-protocol weaning


We compared a computer-driven weaning protocol (SmartCare on Evita XL; Dräger, Lübeck, Germany) with our paper-based nurse-driven weaning protocol.


The ICU is a 10-bed intensivist-led unit in a 500-bed teaching hospital. We compared our paper-based nurse-driven weaning protocol [1] with SmartCare in a prospective cohort study. All consecutive patients receiving mechanical ventilation between May and October 2008 and fulfilling the inclusion criteria were included. Patients were included if the intensivist on his twice daily rounds considered the patient ready for withdrawal of the ventilator and if patients were on pressure support with no more than 50% oxygen and no more than 8 mbar positive end-expiratory pressure, had no fever, had a normal pH, were arousable and had no more than 5 μg/kg/min dopamine. Patients were excluded if they were ready for immediate extubation or if they had a tracheostomy. For the first 3 months of the study, patients were allocated to the paper-based nurse-driven weaning protocol, and for the last 3 months to SmartCare.


The results are presented in Tables 1 and 2. Normally distributed data are presented as the mean and SD, nonparametric data as the median and interquartile range. Thirty-two patients were enrolled in the study. Baseline characteristics were similar in the two groups. The main result was that the median weaning time was significantly shorter in the SmartCare group: 4.5 hours vs. 2.6 hours.

Table 1 Baseline characteristics
Table 2 Results


SmartCare reduces the weaning duration when compared with a paper-based nurse-driven weaning protocol.


  1. Wulff A, Kalkman B, Orsini M, Hoeven M, Velden J, Tangkau P, et al.: The effect of a protocol on the duration of weaning. Intensive Care Med 2004,30(Suppl 1):S21.

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Kleijn, R., Van Spreuwel-Verheijen, M., Kalkman, B. et al. SmartCare is faster than paper-protocol weaning. Crit Care 13 (Suppl 1), P25 (2009).

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