( ential part of their results. The syste...)Computer-Driven System Reduces Patient Mechanical Ventilation Time Significantly,Health

ential part of their results. The system was designed to perform several tasks comparable to a ventilator weaning protocol 24 hours a day, seven days a week. It automatically and gradually reduced the ventilatory assistance to the patient; it performed the equivalent of a spontaneous breathing test; and it displayed an incentive message for the doctor and technicians when the patient was deemed ready to breathe spontaneously.

“The computer-driven weaning protocol does not depend on the willingness or availability of the staff, and full compliance with the weaning protocol is therefore ensured,” said Dr. Brochard.

The investigators said that the message delivered by the computerized system also constituted a strong incentive for the clinician to consider possible removal from ventilator breathing assistance for the patient.

In an editorial on the research in the same issue of the journal, Gordon D. Rubenfeld, M.D., M.Sc., of Harborview Medical Center in Seattle, wrote: “Every year in industrialized nations, hundreds of thousands of people require mechanical ventilation for acute respiratory failure. We have evidence to improve outcomes in these areas with protocols for acute lung injury and weaning, but need strategies to make sure every patient has access to this care.”

“Some physicians may find computer-based protocols more acceptable than sharing responsibility with a respiratory therapist or nurse,” he continued. “Computer-based protocols may be more effective, less expensive or more reliable than implementation by non-physician clinicians. Hopefully, future studies of this technology will explore these questions with appropriate comparisons and measurements. In the meantime, it is refreshing to see the debate move from whether we should have non-physician-driven protocolized mechanical ventilation to how we might demonstrate and implement these protocols.”

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