Hippocrates is alive and weaning in Brazil

doi:10.1186/cc7746

Critical Care

Volume 13
Issue 3

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Commentary

Hippocrates is alive and weaning in Brazil

Nalan Adigüzel¹^,2 , Gökay Güngör¹^,2 and Martin J Tobin¹

¹Division of Pulmonary and Critical Care Medicine, Edward Hines Jr Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, 5th Avenue and Roosevelt Road, Hines, IL 60141, USA

²Respiratory Intensive Care Unit, Süreyyapaşa Chest Diseases and Chest Surgery Teaching and Research Hospital, Basibüyük Street, Istanbul, 34844 Turkey

author email corresponding author email

Critical Care 2009, 13:142doi:10.1186/cc7746


Published:	18 May 2009

See related research by Taniguchi et al., http://ccforum.com/content/13/1/R6 and related letter by Cakar, http://ccforum.com/content/13/4/415

Abstract

In a group of postoperative patients, Taniguchi and coworkers compared the effect of a computerized system for weaning against 'manual care'. The computerized system involved automatic adjustments to the level of pressure support to achieve a target respiratory rate. Manual care involved adjustments to the level of pressure support to keep the ratio of respiratory frequency to tidal volume below 80. The duration of ventilator weaning was equivalent with the two approaches. The level of pressure support, however, was lower with manual care than with computerized ventilation. The study adds support to the notion that ventilator duration is shortened when weaning is contemplated at the earliest possible time. The findings also emphasize the importance of the Hippocratic dictum that patient outcome is improved when care is individualized rather than delivered according to a protocol.