Protocolized weaning from mechanical strategy in chronic obstructive pulmonary disease: respiratory therapists versus physician directed—who guides best?

Weaning from mechanical ventilation is a complex process that is essential to start as soon as possible in chronic obstructive pulmonary disease (COPD) to avoid infectious and non-infectious complications during endotracheal intubation (1). Currently, 25% of the weaning processes are named as difficult weaning (1). In this complex scenario, evaluation and impact of non-protocolized versus protocolized weaning methods on the duration of mechanical ventilation and weaning, intensive care unit (ICU) stay, successful weaning and mortality are still unresolved questions.