Weaning from mechanical ventilation is a critical transition to spontaneous breathing. Weaning protocols can be used to avoid mistakes in this process, which are known to increase overall morbidity and mortality. Our objective was to create a weaning protocol based on current scientific data and to evaluate the results of its use in a combined medical/surgical ICU. Patients included in this controlled, prospective trial had APACHE II score < 25, were on mechanical ventilation for at least 24 hours and met the criteria to start weaning. They were randomly divided in two groups of the same size. Our weaning protocol was used in one group (experimental group) and patients of the other group (control group) had their weaning conducted according to the experience of the ICU staff. 40 patients were included in the trial. Patients of the two groups were comparable in age, gender, APACHE II score, death risk, Pimax and PaO2/FiO2 relation. The f/Vt relation of the experimental group was higher. Results in the control group and in the experimental group were, respectively: 35%(7) and 5%(1) of weaning failure (p = 0.44); 104 +/- 69 hours and 90 +/- 89 hours of total time on mechanical ventilation (p = 0.033); 49 +/- 33 hours and 2 hours of weaning time (p < 0.001); 52% and 2% of weaning time/ventilation time relation (p < 0.001); 20% (4) and 0% of use of noninvasive ventilation; 95% (19) of gradual weaning plus 5% (1) of interruption of ventilation and 100% (20) of autonomy test; 15% (3) and 5% (1) of reintubation; 20% (4) and 0% of death. We concluded that the use of the suggested protocol increased weaning success and decreased the total time on mechanical ventilation, the weaning time, the weaning time/ventilation time relation, the reintubation rate and the overall mortality, resulting in a safer and quicker weaning process.

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