Is automated weaning superior to manual spontaneous breathing trials?

Weaning from mechanical ventilation involves the reduction or withdrawal of ventilatory support in proportion to the patient’s ability to sustain spontaneous ventilation. Protocolized weaning has been shown to reduce weaning duration; however, its weakness lies in the reliance on human intervention. Automated weaning is theoretically superior to manual weaning because of its ability to rapidly recognize deviations from desired behavior and enforce compliance with a standardized weaning strategy unencumbered by external influences. Whether currently available methods for automated weaning fulfill that potential to achieve superiority depends on patient type, care environment, and cause of ventilator dependence.