Intensive Care Medicine

, Volume 31, Issue 10, pp 1446–1450

Computer-driven management of prolonged mechanical ventilation and weaning: a pilot study

  • Lila Bouadma
  • François Lellouche
  • Belen Cabello
  • Solenne Taillé
  • Jordi Mancebo
  • Michel Dojat
  • Laurent Brochard
Brief Report

DOI: 10.1007/s00134-005-2766-2

Cite this article as:
Bouadma, L., Lellouche, F., Cabello, B. et al. Intensive Care Med (2005) 31: 1446. doi:10.1007/s00134-005-2766-2

Abstract

Objective

To evaluate the ability of a computer-driven system (CDS) to manage pressure-support ventilation over prolonged periods and to predict weaning readiness compared to intensivists. The system continuously adapts pressure support, gradually decreases ventilatory assistance when possible, and indicates weaning readiness.

Design and setting

A two-center, prospective, open, clinical, pilot study in medical ICUs of two university hospitals.

Patients and participants

42 consecutive mechanically ventilated patients (60±14 years, SAPS II 39±15), 9 of whom were excluded.

Interventions

As soon as patients could tolerate pressure support, they were ventilated with the CDS. The times of weaning readiness determined by the intensivists and CDS were compared.

Measurements and results

Weaning was successful in 25 patients and failed in 7; unplanned extubation occurred in 1 patient. Time on CDS ventilation was 3±3 days (maximum, 12 days). The CDS detected weaning readiness earlier than the intensivists in 17 patients, and intensivists earlier than the CDS in 4; in 11 patients detection times coincided.

Conclusions

A CDS was successful in fully managing pressure-support ventilation over prolonged periods and often proposed weaning readiness earlier than the intensivists did. Use of this CDS may reduce the duration of mechanical ventilation.

Keywords

Mechanical ventilation Weaning Closed-loop ventilation Automatic weaning 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Lila Bouadma
    • 1
  • François Lellouche
    • 2
  • Belen Cabello
    • 3
  • Solenne Taillé
    • 2
  • Jordi Mancebo
    • 3
  • Michel Dojat
    • 4
  • Laurent Brochard
    • 2
  1. 1.Medical and Infectious Diseases Intensive Care UnitBichat-Claude Bernard Teaching Hospital, AP-HPCréteilFrance
  2. 2.Medical intensive Care UnitHenri Mondor Teaching Hospital, AP-HP, Paris XII University and INSERM U651CréteilFrance
  3. 3.Medical Intensive Care UnitSan Pau HospitalBarcelonaSpain
  4. 4.INSERM/UJF U594, Functional and Metabolic Neuroimaging, LRC CEA 30 VGrenoble Teaching HospitalGrenobleFrance