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SmartCare™ versus non-automated mechanical ventilation strategies on discontinuation time for adults in the postoperative period

  • Protocol
  • Intervention

Authors

  • Karen EA Burns,

    Corresponding author
    1. Keenan Research Centre/Li Ka Shing Knowledge Institute, Interdepartmental Division of Critical Care and the University of Toronto, Toronto, Ontario, Canada
    • Karen EA Burns, Interdepartmental Division of Critical Care and the University of Toronto, Keenan Research Centre/Li Ka Shing Knowledge Institute, St Michael's Hospital, 30, Bond Street, Rm 4-045 Queen Wing, Toronto, Ontario, M5B 1WB, Canada. BurnsK@smh.ca. burnske2@hotmail.com.

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  • Francois Lellouche,

    1. Hopital Laval, Intensive Care Department, St Foy, Quebec, Canada
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  • Rosane Nisenbaum,

    1. St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Centre for Research in Inner City Health, in The Keenan Research Centre, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
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  • Martin Lessard,

    1. Centre hospitalier affilié universitaire de Québec, Department of Anesthesia and Critical care, Quebec City, Quebec, Canada
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  • Jan O Friedrich,

    1. University of Toronto and Keenan Research Centre/Li Ka Shing Knowledge Institute, Critical Care and Medicine Departments, St. Michael's Hospital, Interdepartmental Division of Critical Care, Toronto, Ontario, Canada
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  • Bronagh Blackwood

    1. Queen's University Belfast, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland, UK
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Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

The primary objective of the review is to compare the time to mechanical ventilation discontinuation (time from randomization to extubation as defined by study authors) between SmartCare™ and non-automated mechanical ventilation strategies in adult postoperative patients.

The secondary objectives are to ascertain differences between SmartCare™ and non-automated mechanical ventilation discontinuation strategies on the following clinical outcomes:

  1. time to successful extubation (time from randomization to successful extubation as defined by study authors);

  2. time to first SBT and first successful SBT (time from randomization to first SBT and first successful SBT as defined by study authors, respectively);

  3. mortality (the most protracted report period and at time points reported by study authors);

  4. total duration of ventilation (time from initiation of invasive ventilation to extubation as defined by the study authors);

  5. intensive care unit (ICU) length of stay;

  6. use of non-invasive ventilation (NIV) following extubation;

  7. adverse events (including but not limited to reintubation, self-extubation, the requirement for tracheostomy and prolonged ventilation as defined by the study authors);

  8. hospital length of stay.

The third objective of our review is to use subgroup analyses to explore variation in discontinuation time, ICU length of stay, mortality, use of NIV and reintubation by the type of (i) clinician primarily involved in implementing the SmartCare™ discontinuation strategy, (ii) ICU (as a reflection of the population involved), and (iii) the non-automated discontinuation strategy utilized.

We plan to conduct a sensitivity analysis evaluating variation in discontinuation time based on the (iv) methodological quality (low or moderate versus high risk of bias) of the included studies.