The impact of an intensive care telemedicine program on weaning from invasive ventilation: a secondary analysis of the ERIC trial
In brief
Telemedicine rounding shortens ventilation by about two days in successfully weaned ICU patients
In a secondary analysis of the ERIC trial, daily tele-intensivist rounds increased spontaneous breathing trials from 27% to 51% of patient days but did not raise weaning success rates. Among patients who did wean, median invasive ventilation fell from nine to seven days, suggesting telemedicine can accelerate liberation from the ventilator without improving overall weaning odds.
- Journal
- Critical care (London, England) (Q1)
- Published
- 7 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Moritz F Adam, Julius J Grunow, Andreas Edel, Karin Steinecke, Friederike S Schuster, Claudia D Spies, et al.
- PMID
- 42568095
- DOI
- 10.1186/s13054-026-06234-z
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (paper of the day, 9 August 2026): Telemedicine program shortens invasive ventilation weaning time
- Picked for Health Informatics (paper of the day, 9 August 2026).
Abstract
BACKGROUND: ICU patients commonly require invasive mechanical ventilation. Although weaning from ventilation is crucial for patient outcomes, it is commonly not performed according to guideline recommendations. We investigated if a complex telemedicine intervention improves the weaning process and outcomes. METHODS: This is a secondary analysis of the stepped-wedge cluster-randomized controlled Enhanced Recovery after Intensive Care (ERIC) trial, which was conducted among ten clusters of ICUs in the metropolitan area of Berlin, Germany. ERIC examined the impact of a complex telemedicine intervention, which included daily telemedicine rounding by an intensivist and ICU nurse, on the adherence to eight quality indicators of ICU care. We analyzed patients who received invasive mechanical ventilation for at least two consecutive days and at least one spontaneous breathing trial (SBT). We investigated the impact of the intervention on the weaning process and weaning outcomes using descriptive statistics and mixed-effects regressions. RESULTS: Of 1,463 patients enrolled in the trial, 308 patients were analyzed (control condition: 55; intervention condition: 253). Patients in the intervention group received significantly more SBTs than patients in the control group (51% vs 27% of the patient days; p < 0.001). There was no difference between the groups with respect to the weaning classification (p = 0.21), weaning success rate (28% vs 36%; p = 0.32), and time from the first SBT to successful weaning (2 [IQR 1, 5] vs 4 [IQR 1, 13] days; p = 0.12). The median time of invasive mechanical ventilation of successfully weaned patients was significantly shorter in the intervention than in the control group (7 [IQR 4, 10] vs 9 [IQR 6, 20] days; p = 0.031). In our multivariable regressions, the intervention was not associated with weaning success (OR for weaning failure: 1.45 [95%-CI 0.71-2.95]; p = 0.302), but with a shorter time between the first SBT and successful weaning (β = 0.56 [0.32-0.98]; p = 0.042). CONCLUSIONS: Although ICU telemedicine did not improve the weaning success rate, our findings indicate that it facilitates the exploitation of existing weaning potential by ensuring more frequent SBTs and thereby shortening ventilation duration of successfully weaned patients. The study is the first to highlight the potential of telemedicine to enhance ICU weaning practices. REGISTRATION: www. CLINICALTRIALS: gov (Identifier: NCT03671447; first submitted on August 22, 2018).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.