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Wean earlier and automatically with new technology (the WEAN study). A multicenter, pilot randomized controlled trial
Karen E A Burns1, Maureen O Meade, Martin R Lessard
1Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
American Journal of Respiratory and Critical Care Medicine
|March 26, 2013
Summary
Automated weaning in critically ill adults showed faster liberation from mechanical ventilation compared to a standardized protocol. This approach demonstrated promising outcomes, including reduced time to extubation and fewer tracheostomies.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Clinical Trials
Background:
- Automated weaning has not been previously compared to paper-based protocols in North America.
- Evaluating automated weaning requires assessing clinician acceptance and protocol adherence.
Purpose of the Study:
- To compare automated weaning with protocolized weaning in critically ill adults.
- To assess clinician compliance and acceptance of weaning and sedation protocols.
- To evaluate the impact on patient recruitment and clinical outcomes.
Main Methods:
- A pilot randomized trial was conducted in nine Canadian intensive care units.
- Critically ill adults requiring >24 hours of mechanical ventilation were randomized.
- Both groups utilized pressure support, spontaneous breathing trials, and standardized sedation and extubation criteria.
Main Results:
- 92 patients were recruited over 26 months.
- Automated weaning significantly reduced time to spontaneous breathing trial, extubation, and successful extubation.
- Fewer tracheostomies and episodes of protracted ventilation were observed in the automated weaning group.
Conclusions:
- Automated weaning demonstrated promising outcomes compared to a standardized protocol.
- Further investigation is warranted for automated weaning strategies.
- Protocol modifications may enhance compliance, recruitment, and feasibility.
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