Update in computer-driven weaning from mechanical ventilation

Rose, L, Presneill, J and Cade, J 2007, 'Update in computer-driven weaning from mechanical ventilation', Anaesthesia and Intensive Care, vol. 35, pp. 213-221.


Document type: Journal Article
Collection: Journal Articles

Title Update in computer-driven weaning from mechanical ventilation
Author(s) Rose, L
Presneill, J
Cade, J
Year 2007
Journal name Anaesthesia and Intensive Care
Volume number 35
Start page 213
End page 221
Total pages 9
Publisher Australian Society of Anaesthetists
Abstract Weaning from mechanical ventilation is a complex process requiring assessment and interpretation of both objective and subjective clinical parameters. For many years, automated computerised systems for various medical processes, including respiratory management, have been proposed to optimise decision-making and reduce variation amongst clinicians. SmartCare/PS, available since 2003 as a software application for the EvitaXL ventilator (Drager Medical AG and Co. KG, Lubeck, Germany), is one of the first such ventilator systems to be made commercially available. SmartCare/PS can be described as a knowledge-based weaning system, which adjusts pressure support based on measurement of the patient's respiratory status, specifically the spontaneous respiratory rate, tidal volume and end-tidal carbon dioxide with the aim of optimising the weaning process. The primary proposed advantage of this system is an ability to provide management of ventilatory weaning through continuous physiological monitoring and real-time interventions. The relatively small number of available clinical studies indicate the system is able to deliver appropriate ventilation during pressure support weaning from both short-term and prolonged ventilation. Of potential clinical note, a recent study suggested that use of SmartCare/PS might be associated with useful reductions in the duration of weaning compared to existing clinical practice using weaning protocols. One recently published randomised trial supports this conclusion. However, given the known large variation in international critical care ventilatory practices further randomised trials are desirable.
Subject Nutritional Physiology
Keyword(s) Proportional-Assist Ventilation
Inspiratory Pressure Support
Knowledge-Based System
Intensive-Care-Unit
Adaptive Support
Automatic Selection
Cardiac-Surgery
Extubation
Management
Trial
ISSN 0310-057X
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