Critical Care

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Commentary

Hippocrates is alive and weaning in Brazil

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

Author Affiliations

1 Division 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

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

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

Published: 18 May 2009

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.