Early Weaning Protocols from Mechanical Ventilation: A Systematic Review of Their Impact on ICU Length of Stay

Abstract

Mechanical ventilation is a critical life-support intervention in intensive care units (ICUs), yet prolonged dependence significantly increases morbidity, healthcare costs, and ICU length of stay (LOS). Early weaning protocols have been developed as structured approaches to safely and efficiently facilitate patient liberation from mechanical ventilation. This systematic review aims to evaluate the impact of early weaning protocols on ICU LOS by synthesizing recent evidence from randomized controlled trials and observational studies. Comprehensive searches were conducted across PubMed, Scopus, Web of Science, and Cochrane Library for studies published between 2010 and 2024. Eligible studies included adult ICU patients undergoing protocolized or spontaneous breathing trial (SBT)-based weaning strategies compared to conventional physician-directed methods. The majority of studies demonstrated that early weaning protocols significantly reduced ICU LOS, decreased duration of mechanical ventilation, and lowered the incidence of ventilation-associated complications. Additionally, standardized protocols improved clinical decision-making, enhanced patient outcomes, and optimized ICU resource utilization without increasing reintubation or mortality rates. The findings support the integration of early weaning protocols as an evidence-based strategy to reduce ICU burden and improve patient recovery trajectories. Further research is recommended to explore individualized, technology-assisted weaning models