Our objective was to compare mechanical ventilator weaning duration for critically ill adults and children when managed with automated systems versus non-automated strategies.
Decreasing the duration of mechanical ventilation might lead to medical and economic benefits: a shorter mechanical ventilation duration decreases the risk of ventilator-associated morbidity, for example, complications caused by loss of airway defense mechanisms such as nosocomial pneumonia [ 3- 5].
Perhaps more importantly, poor patient-ventilator asynchrony has been associated with increased respiratory muscle workload [ 11], prolonged mechanical ventilation duration [ 6, 12], and poorer outcome in difficult-to-wean patients [ 13].
Despite application of preventive measures in bundles, ventilator-associated pneumonia (VAP) remains the most common nosocomial infection, leading to increases in mechanical ventilation duration, ICU stay and healthcare costs [ 1].
We studied the impact of timing of tracheotomy on the duration of mechanical ventilation, duration of weaning, length of stay in the ICU (LOS), outcome in 28 days, incidence of ventilator-associated pneumonia (VAP), and days of sedation administration.
The factors which were found to affect duration period on mechanical ventilator and length of stay in the unit were location before ICU admission, category of surgery/condition and also referring department/condition and this was consistent with what was found in other studies [ 35, 36].
Our study was not sufficiently powered to identify significant differences in overall mortality, duration of mechanical ventilator use, and length of ICU and hospital stay among the three groups, although we found a trend toward a longer duration of mechanical ventilator use and ICU and hospital stay in patients with lower second cortisol levels.
Demographic and clinical characteristics included morphine usage, blood transfusion, duration of mechanical ventilator support and length of ICU stay were recorded.
The results showed a decrease in mechanical ventilator days and ICU duration of stay in the negative pressure ventilation group as compared with the NIPPV group.
Secondary outcomes (mechanical ventilator days [mean 6.7 days], duration of ICU stay [mean 9.3 days], and reintubation rate [10.6%]) were similar to those in the historical control cohort.
22 In critically ills adults in intensive care non-invasive weaning is associated with decreased mortality, ventilator associated pneumonia, length of stay in intensive care and hospital, total duration of mechanical ventilation, and duration of invasive ventilation.
