Trial reportCritical care (London, England)2015
Smart Care™ versus respiratory physiotherapy-driven manual weaning for critically ill adult patients: a randomized controlled trial.
Trial report in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02122016 (Weaning With Smartcare in Mechanically Ventilated Patients in the ICU - a Controlled and Randomized Study), which is not on this map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Weaning With Smartcare in Mechanically Ventilated Patients in the ICU - a Controlled and Randomized Study
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children.The Cochrane database of systematic reviews · 2025Pooled it
- Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- A Randomized Controlled Clinical Trial Investigating the Weaning Process From Mechanical Ventilation in Elderly Patients With Dementia.The clinical respiratory journal · 2024Trial
- JICS education: mechanical ventilation - physiology, mechanism and modes.Journal of the Intensive Care Society · 2026Review
- Prediction of Spontaneous Breathing Trial Outcome in Critically Ill-Ventilated Patients Using Deep Learning: Development and Verification Study.JMIR medical informatics · 2025Article
- Comparison of clinical outcomes in critical patients undergoing different mechanical ventilation modes: a systematic review and network meta-analysis.Frontiers in medicine · 2023Article
- Methods of liberation from mechanical ventilation: Which one is best?Frontiers in medicine · 2022Article
- Methods of Weaning From Mechanical Ventilation in Adult: A Network Meta-Analysis.Frontiers in medicine · 2021Article
- When a Ventilator Takes Autonomous Decisions without Seeking Approbation nor Warning Clinicians: A Case Series.International medical case reports journal · 2020Article
- The patient needing prolonged mechanical ventilation: a narrative review.Multidisciplinary respiratory medicine · 2018Review
- Clinical study replicability and the pursuit of excellence.Critical care (London, England) · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA recent meta-analysis showed that weaning with SmartCare™ (Dräger, Lübeck, Germany) significantly decreased weaning time in critically ill patients. However, its utility compared with respiratory physiotherapist-protocolized weaning is still a matter of debate. We hypothesized that weaning with SmartCare™ would be as effective as respiratory physiotherapy-driven weaning in critically ill patients.
methodsAdult critically ill patients mechanically ventilated for more than 24 hours in the adult intensive care unit of the Albert Einstein Hospital, São Paulo, Brazil, were randomly assigned to be weaned either by progressive discontinuation of pressure support ventilation (PSV) with SmartCare™. Demographic data, respiratory function parameters, level of PSV, tidal volume (VT), positive end-expiratory pressure (PEEP), inspired oxygen fraction (FIO2), peripheral oxygen saturation (SpO2), end-tidal carbon dioxide concentration (EtCO2) and airway occlusion pressure at 0.1 second (P0.1) were recorded at the beginning of the weaning process and before extubation. Mechanical ventilation time, weaning duration and rate of extubation failure were compared.
resultsSeventy patients were enrolled 35 in each group. There was no difference between the two groups concerning age, sex or diagnosis at study entry. There was no difference in maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity or rapid shallow breathing index at the beginning of the weaning trial. PEEP, VT, FIO2, SpO2, respiratory rate, EtCO2 and P0.1 were similar between the two groups, but PSV was not (median: 8 vs. 10 cmH2O; p =0.007). When the patients were ready for extubation, PSV (8 vs. 5 cmH2O; p =0.015) and PEEP (8 vs. 5 cmH2O; p <0.001) were significantly higher in the respiratory physiotherapy-driven weaning group. Total duration of mechanical ventilation (3.5 [2.0-7.3] days vs. 4.1 [2.7-7.1] days; p =0.467) and extubation failure (2 vs. 2; p =1.00) were similar between the two groups. Weaning duration was shorter in the respiratory physiotherapy-driven weaning group (60 [50-80] minutes vs. 110 [80-130] minutes; p <0.001).
conclusionA respiratory physiotherapy-driven weaning protocol can decrease weaning time compared with an automatic system, as it takes into account individual weaning difficulties.
trial registrationClinicaltrials.gov Identifier: NCT02122016 . Date of Registration: 27 August 2013.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.