Lation. Methods All patients of a 50-bed ICU with mechanical ventilation >24 hours were included. From June 2005 to Vericiguat biological activity September 2005 (Audit I), patients were examined daily for SRP >30? low tidal volume ventilation, DVTP, and SUP by an independent task force. Afterwards, nurses and physicians were trained for the monitored treatments. Audit II was then performed from March 2006 to June 2006. Results One hundred and thirty-three patients (1,389 ventilatordays) were included in Audit I, 141 patients (1,002 ventilator-days) in Audit II. Data are expressed as the median (interquartile range) or percentage of implementation per ventilator-days (Table 1). On average, low tidal volume ventilation was adopted. DVTP and SUP were well implemented without training. There was no effect on frequency of pneumonia, ICU length of stay, or survival.Table 1 (abstract P171) Audit I APACHE II SRP ( ) TV (ml/kg) DVTP ( ) SUP ( ) Days on ventilation 24 (10) 24.9 6.3 (2.2) 89.5 94.5 6.0 (13) Audit II 25 (11) 49.6 6.4 (2.3) 91.9 94.9 4.0 (7) P 0.387 <0.001 0.154 0.048 0.712 0.(ITSB) using a T-tube as two methods of weaning in a surgical ICU. Methods A total of 104 patients who had been ventilated for more than 48 hours in the postoperative period from October 2005 to October 2006 were enrolled in the study. After fulfilling the weaning checklist they were randomly assigned into two groups: SIMV+PSV group (n = 53), and ITSB group (n = 51). In patients assigned to the SIMV+PSV group, the ventilator rate was initially set at 6? breaths/minute plus PSV of 15 cmH2O and then both reduced, if possible, by 2 breaths/minute and 2 cmH2O each time. Patients able to maintain adequate ventilation with SIMV of 2 breaths/minute and PSV of 5 cmH2O for at least 2 hours without signs of distress were extubated. Patients assigned to the ITSB group were disconnected from the ventilator and allowed to breathe spontaneously through a T-tube circuit. The duration of the trials was gradually increased. Between the trials, assist ontrol ventilation was provided for at least 1 hour. Patients able to breathe on their own for at least 2 hours without signs of distress were extubated. Results Until the first attempt was made for weaning, all patients received assist ontrol ventilation because of haemodynamic instability. The following underlying conditions were present: chronic obstructive pulmonary disease in 67 patients, neuromuscular disorders in nine patients, acute lung injury as a result of surgery in 14 patients, asthma in six patients and miscellaneous causes in eight patients. The duration of mechanical ventilation before weaning was 2.5 ?0.5 days in the SIMV+PSV group vs 2.4 ?0.4 days in the ITSB group (P = 0.02) and the duration of weaning was 6.2 ?0.23 hours vs 8.3 ?0.44 hours in the two groups, respectively (P < 0.01). Patients who remained extubated for 48 hours were classified as having successful extubation ?the rate of successful extubation in the first 24 hours of starting weaning was higher for PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20800733 the SIMV group (79.2 ) than in the ITSB group (64.7 , P < 0.01). The total duration of mechanical ventilation was 3.3 ?0.3 days vs 5.2 ?1.1 days and the ICU length of stay was 5.6 ?1 days vs 7.5 ?1.7 days in the two groups, respectively (P < 0.01). Conclusions The use of SIMV+PSV as a weaning method in the surgical ICU lead to shorter duration of weaning, a higher rate of successful extubation, a shorter duration of mechanical ventilation and less ICU stay than the use of ITSB.Conc.