Computerized Weaning Reduces Ventilation Time

A computer-driven system can significantly reduce the duration of mechanical ventilation and length of stay in the intensive care unit (ICU) for patients with acute respiratory failure, according to a new study.

Researchers from the Hôpital Henri Mondor (Créteil, France) and four other medical-surgical ICUs in Barcelona (Spain), Brussels (Belgium), Paris (France), and Geneva (Switzerland) weaned 74 patients using the computer-driven system and 70 patients with the traditional physician-controlled weaning process. The total number of ventilator-related complications such as reintubation, self-removal from ventilator assistance, need for noninvasive ventilation, mechanical ventilation longer than 21 days, and tracheotomy (surgically opening the trachea), was reduced by 30% in the computer-driven weaning group.

The system used was designed to perform several tasks comparable to a ventilator-
weaning protocol in a process that took place 24 hours a day, seven days a week. The computerized protocol included an automatic gradual reduction in pressure support, automatic performance of spontaneous breathing trials, and generation of an incentive message when the patient's spontaneous breathing trial was successfully completed and the patient was deemed ready to breathe spontaneously.

"The computer-driven weaning protocol does not depend on the willingness or availability of the staff, and full compliance with the weaning protocol is therefore ensured,” said lead author Laurent J. Brochard, M.D, of Hôpital Henri Mondor. "The system used in the study was developed several years ago and has been repeatedly evaluated since then; it ensures that the desired ventilation protocol is applied.”

The results appeared in the October 15, 2006, issue of the American Journal of Respiratory and Critical Care Medicine.

The investigators noted that the message delivered by the computerized system also constituted a strong incentive for the clinician to consider possible removal from ventilator-breathing assistance for the patient.



Related Links:
Hôpital Henri Mondor