Respiratory failure & ventilation
Effect of Automated Closed-Loop Ventilation vs Protocolized Conventional Ventilation on Ventilator-Free Days in Critically Ill Adults: A Randomized Clinical Trial
Authors' conclusion
Among critically ill adults receiving invasive mechanical ventilation, early use of an automated closed-loop ventilation system did not increase ventilator-free days at day 28 compared with protocolized conventional ventilation.
Study context
- Population
- Adults within 1 hour of starting invasive ventilation and expected to require ventilation ≥24 hours, 7 intensive care units (ICUs) in the Netherlands and Switzerland, 2020–20251,201 (79%) in modified ITT analysis
- Participants
- 1,514 adults
- Comparison
- Closed-loop ventilation vs Conventional ventilation
- Closed-loop ventilationn = 602
- Conventional ventilationn = 599reference
- Primary endpoint
- Ventilator-free days (days alive and free from invasive ventilation)
- Follow-up
- Day 28
Methodological detailsinternational, multicentre, 1:1 randomisation, modified ITT analysis
- International
- Multicentre
- 1:1 randomisation
- Modified ITT analysis
Primary result
As reported in the abstract
Odds ratio
0.91
95% CI 0.77–1.06
P = 0.23
By group
Closed-loop ventilation vs Conventional ventilation
OR 0.91 (95% CI 0.77–1.06); P = 0.23
Secondary outcomes
Components of the primary outcome (duration of ventilation in survivors, 28-day mortality)
- No differences between groups
Other secondary outcomes (mortality, ICU and hospital LOS, ventilation quality)
- No differences except ventilation quality, higher with closed-loop ventilation
Safety
Severe hypercapnia and hypoxemia; rescue therapies (primarily prone positioning)
- Less frequent severe hypercapnia and hypoxemia and fewer rescue therapies in the closed-loop group vs conventional
- Non-statistically significant after multiplicity adjustment
Original publication
Effect of Automated Closed-Loop Ventilation vs Protocolized Conventional Ventilation on Ventilator-Free Days in Critically Ill Adults: A Randomized Clinical Trial. JAMA. Published 10 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →