%0 Journal Article %1 Schadler.2012 %A Schädler, Dirk %A Engel, Christoph %A Elke, Gunnar %A Pulletz, Sven %A Haake, Nils %A Frerichs, Inéz %A Zick, Günther %A Scholz, Jens %A Weiler, Norbert %D 2012 %J American journal of respiratory and critical care medicine %K Aged Automation/methods Cardiac_Surgical_Procedures Female Follow-Up_Studies Humans Intensive_Care_Units Male Middle_Aged Pressure Prospective_Studies Respiration,_Artificial Ventilator_Weaning/methods %N 6 %P 637–644 %T Automatic control of pressure support for ventilator weaning in surgical intensive care patients %V 185 %X RATIONALE\r\nDespite its ability to reduce overall ventilation time, protocol-guided weaning from mechanical ventilation is not routinely used in daily clinical practice. Clinical implementation of weaning protocols could be facilitated by integration of knowledge-based, closed-loop controlled protocols into respirators.\r\nOBJECTIVES\r\nTo determine whether automated weaning decreases overall ventilation time compared with weaning based on a standardized written protocol in an unselected surgical patient population.\r\nMETHODS\r\nIn this prospective controlled trial patients ventilated for longer than 9 hours were randomly allocated to receive either weaning with automatic control of pressure support ventilation (automated-weaning group) or weaning based on a standardized written protocol (control group) using the same ventilation mode. The primary end point of the study was overall ventilation time.\r\nMEASUREMENTS AND MAIN RESULTS\r\nOverall ventilation time (median 25th and 75th percentile) did not significantly differ between the automated-weaning (31 19-101 h; n = 150) and control groups (39 20-118 h; n = 150; P = 0.178). Patients who underwent cardiac surgery (n = 132) exhibited significantly shorter overall ventilation times in the automated-weaning (24 18-57 h) than in the control group (35 20-93 h; P = 0.035). The automated-weaning group exhibited shorter ventilation times until the first spontaneous breathing trial (1 0-15 vs. 9 1-51 h; P = 0.001) and a trend toward fewer tracheostomies (17 vs. 28; P = 0.075).\r\nCONCLUSIONS\r\nOverall ventilation times did not significantly differ between weaning using automatic control of pressure support ventilation and weaning based on a standardized written protocol. Patients after cardiac surgery may benefit from automated weaning. Implementation of additional control variables besides the level of pressure support may further improve automated-weaning systems. Clinical trial registered with www.clinicaltrials.gov (NCT 00445289).

@article{Schadler.2012, abstract = {RATIONALE\r\nDespite its ability to reduce overall ventilation time, protocol-guided weaning from mechanical ventilation is not routinely used in daily clinical practice. Clinical implementation of weaning protocols could be facilitated by integration of knowledge-based, closed-loop controlled protocols into respirators.\r\nOBJECTIVES\r\nTo determine whether automated weaning decreases overall ventilation time compared with weaning based on a standardized written protocol in an unselected surgical patient population.\r\nMETHODS\r\nIn this prospective controlled trial patients ventilated for longer than 9 hours were randomly allocated to receive either weaning with automatic control of pressure support ventilation (automated-weaning group) or weaning based on a standardized written protocol (control group) using the same ventilation mode. The primary end point of the study was overall ventilation time.\r\nMEASUREMENTS AND MAIN RESULTS\r\nOverall ventilation time (median [25th and 75th percentile]) did not significantly differ between the automated-weaning (31 [19-101] h; n = 150) and control groups (39 [20-118] h; n = 150; P = 0.178). Patients who underwent cardiac surgery (n = 132) exhibited significantly shorter overall ventilation times in the automated-weaning (24 [18-57] h) than in the control group (35 [20-93] h; P = 0.035). The automated-weaning group exhibited shorter ventilation times until the first spontaneous breathing trial (1 [0-15] vs. 9 [1-51] h; P = 0.001) and a trend toward fewer tracheostomies (17 vs. 28; P = 0.075).\r\nCONCLUSIONS\r\nOverall ventilation times did not significantly differ between weaning using automatic control of pressure support ventilation and weaning based on a standardized written protocol. Patients after cardiac surgery may benefit from automated weaning. Implementation of additional control variables besides the level of pressure support may further improve automated-weaning systems. Clinical trial registered with www.clinicaltrials.gov (NCT 00445289).}, added-at = {2014-10-13T18:25:00.000+0200}, author = {Schädler, Dirk and Engel, Christoph and Elke, Gunnar and Pulletz, Sven and Haake, Nils and Frerichs, Inéz and Zick, Günther and Scholz, Jens and Weiler, Norbert}, biburl = {https://www.bibsonomy.org/bibtex/29d770cea02c890e25017caeb3e243708/drtester}, interhash = {0a001fee0426c2468dda1d81b5984245}, intrahash = {9d770cea02c890e25017caeb3e243708}, journal = {American journal of respiratory and critical care medicine}, keywords = {Aged Automation/methods Cardiac_Surgical_Procedures Female Follow-Up_Studies Humans Intensive_Care_Units Male Middle_Aged Pressure Prospective_Studies Respiration,_Artificial Ventilator_Weaning/methods}, number = 6, pages = {637–644}, timestamp = {2014-10-13T18:25:00.000+0200}, title = {Automatic control of pressure support for ventilator weaning in surgical intensive care patients}, volume = 185, year = 2012 }