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