Weaning protocols reduce the duration of mechanical ventilation in critically ill adults

Added March 16, 2020

Citation: Blackwood B, Burns KEA, Cardwell CR, et al. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database of Systematic Reviews 2014; (11): CD006904.

What is this? Some patients with COVID-19 will become critically ill and need help with their breathing. This might be provided by mechanical ventilation (MV) in an intensive care unit (ICU). Clinicians use a variety of methods to bring people off MV as they recover, including formal weaning protocols.

In this Cochrane systematic review, the authors searched for randomized and quasi-randomized trials of the effects of weaning protocols on reducing the time that critically ill patients spend on MV. They did not restrict by language of publication and conducted their searches in January 2014. They identified 13 studies in which clinicians used weaning protocols to guide them when reducing MV support and four in which MV was reduced automatically by computers programmed to follow a protocol.

What works: Using weaning protocols reduces the average total time spent on MV, the duration of weaning and length of stay in the ICU, without causing any additional harms.

What doesn’t work: Protocols were not found to be beneficial in neurosurgical patients.

What’s uncertain: A wide variety of types of weaning protocol were studied and it is uncertain which protocols work best for which patients.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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