A Computer-controlled Ventilator Weaning System

Weaning of patients from mechanical ventilation is a time-consuming, labor-intensive process. Because most weaning decisions are based on objective data, we tested a computer-directed weaning system on postoperative patients. We developed an automatic, computer-controlled ventilator weaning system which interfaces a laptop computer to a ventilator and a pulse oximeter. The laptop computer program accesses patient data through the ventilator and pulse oximeter to make weaning decisions. The computer directly controls the ventilator through an interface developed for this system. We tested the system in nine postoperative patients who met the following criteria: negative inspiratory force ≤ - 20 cm H 2 O, vital capacity >10 ml/kg, inspired oxygen concentration ≤40 percent, and satisfactory arterial blood gas parameters (pH between 7.32 and 7.48, P co 2 between 32 and 48, and oxygen saturation ≥90 percent). The computer decreased the SIMV rate by 2 breaths/min every 5 min until a rate of 2 breaths/min was reached, then decreased pressure support by 4 cm H 2 O every 5 min as long as the patient met the following criteria: respiratory rate between 8 and 25 breaths/min, minute ventilation between 6 and 14 L, and pulse oximeter oxygen saturation ≥90 percent. If unsatisfactory weaning criteria were noted, the system automatically returned the patient to the previous weaning level. We successfully weaned nine patients using the system. Additional studies are underway to determine if this system can be used in medical patients. We believe this computer-controlled ventilator weaning system can be used successfully in patients requiring mechanical ventilation and may decrease the time and cost associated with the care of these patients.