2016, Number 4
Med Crit 2016; 30 (4)
Effectiveness of automated weaning protocol (SmartCare®) compared to nonautomated weaning protocols for mechanical ventilation withdrawal in adult patients on Intensive Care Unit
Aguilar AMF, Escalante CA, Góngora MJJ, López AVG, Cetina CMA, Magdaleno LGA
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ABSTRACTBackground: Weaning from mechanical ventilation takes up to 40% from mechanical ventilation length. Last generation ventilators came up with new automated weaning protocols, based on respiratory dynamic measures to adjust onto patients demands; the objective of this protocol is a faster and easier transition prior extubation and prevent extubation failure. In this study a comparison is made between nonautomated weaning protocols vs an automated protocol.
Methods: This study is an open, controlled, clinical trial; patients were randomized in three groups by the time they were admitted to the ICU. S group, correspond to automated weaning protocol SmartCare®, P group correspond to nonautomated weaning protocol Support Pressure and T group correspond to nonautomated weaning protocol T piece, until 30 patients were enrolled in every group. At ICU admission data about demographic and severity scales was collected. Every patient was ventilated with mechanical ventilator Draeger Evita Xl® model. By the time weaning protocol started, measurement of haemodynamic variables were taken in 5 different times; it was established as a successful extubation once the patient fulfill 48 hours without necessity of invasive or non invasive respiratory mechanical support.
Results: Average weaning time on S group was 93 ± 12 min., P group was 189 ± 21 min. and in T group was 198 ± 17 min., while comparing the outcomes an statistically significant difference was found (p = 0.002). A weaning time reduction of 50.7% was observed with SmartCare® protocol while compared to Support Pressure and 53% reduction while comparing to T piece.
Conclusion: Automated weaning protocol SmartCare® is more effective than nonautomated protocols Support Pressure and T Piece in mechanical ventilation withdrawal.