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Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children

  1. Louise Rose1,*,
  2. Marcus J Schultz2,
  3. Chris R Cardwell3,
  4. Philippe Jouvet4,
  5. Danny F McAuley5,6,
  6. Bronagh Blackwood7

Editorial Group: Cochrane Anaesthesia Group

Published Online: 6 JUN 2013

Assessed as up-to-date: 29 AUG 2012

DOI: 10.1002/14651858.CD009235.pub2


How to Cite

Rose L, Schultz MJ, Cardwell CR, Jouvet P, McAuley DF, Blackwood B. Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD009235. DOI: 10.1002/14651858.CD009235.pub2.

Author Information

  1. 1

    University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, Toronto, ON, Canada

  2. 2

    Academic Medical Center, University of Amsterdam, Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam, Netherlands

  3. 3

    Queen's University Belfast, Centre for Public Health, Belfast, Northern Ireland, UK

  4. 4

    Sainte-Justine Hospital, University of Montreal, Department of Pediatrics, Montreal, Quebec, Canada

  5. 5

    Queen's University of Belfast, Centre for Infection and Immunity, Belfast, Northern Ireland, UK

  6. 6

    Royal Victoria Hospital, Regional Intensive Care Unit, Belfast, UK

  7. 7

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

*Louise Rose, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada. louise.rose@utoronto.ca.

Publication History

  1. Publication Status: New
  2. Published Online: 6 JUN 2013

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This is not the most recent version of the article. View current version (10 JUN 2014)

[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 3]
Figure 3. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 4]
Figure 4. Forest plot of comparison: 1 Primary analysis: automated closed loop system versus non-automated system, outcome: 1.2 Total duration of weaning by automated system (log hours).
[Figure 5]
Figure 5. Forest plot of comparison: 1 Primary analysis: automated closed loop system versus non-automated system, outcome: 1.5 Secondary outcome 2: duration of ventilation by study population (log hours).
[Figure 6]
Figure 6. Funnel plot of comparison: 1 Primary analysis: automated closed loop system versus non-automated system, outcome: 1.2 Total duration of weaning by automated system (log hours).
[Analysis 1.1]
Analysis 1.1. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 1 Total duration of weaning by study population.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 2 Total duration of weaning by automated system.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 3 Total duration of weaning by non-automated strategy (control arm).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 4 Secondary outcome 1: time from randomization to first extubation.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 5 Secondary outcome 2: duration of ventilation by study population.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 6 Secondary outcome 2: duration of ventilation by automated system.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 7 Secondary outcome 2: duration of ventilation by non-automated strategy (control arm).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 8 Secondary outcome 3: time from intubation to randomization.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 9 Secondary outcome 5.1: mortality.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 10 Secondary outcome 6.1: hospital length of stay.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 11 Secondary outcome 6.2: ICU length of stay by ICU population.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 12 Secondary outcome 6.2: ICU length of stay by automated system.
[Analysis 1.13]
Analysis 1.13. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 13 Secondary outcome 7.1: reintubation.
[Analysis 1.14]
Analysis 1.14. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 14 Secondary outcome 7.2: self-extubation.
[Analysis 1.15]
Analysis 1.15. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 15 Secondary outcome 7.3: non invasive ventilation.
[Analysis 1.16]
Analysis 1.16. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 16 Secondary outcome 7.3: prolonged mechanical ventilation.
[Analysis 1.17]
Analysis 1.17. Comparison 1 Primary analysis: automated closed loop system versus non-automated system, Outcome 17 Secondary outcome 7.5: tracheostomy.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 1 Total duration of weaning by ICU population.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 2 Total duration of weaning by automated system.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 3 Total duration of weaning by non-automated strategy (control arm).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 4 Secondary outcome 1: time from randomization to first extubation.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 5 Secondary outcome 2: total duration of ventilation.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 6 Secondary outcome 3: time from intubation to randomization.
[Analysis 2.7]
Analysis 2.7. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 7 Secondary Outcome 6.1: hospital length of stay.
[Analysis 2.8]
Analysis 2.8. Comparison 2 Sensitivity analysis: automated closed loop system versus non-automated system, unlogged data duration of weaning, Outcome 8 Secondary outcome 6.2: ICU length of stay.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Sensitivity analysis: automated closed loop system versus non-automated system excluding high risk of bias studies, Outcome 1 Total duration of weaning.