Comparison 1. Primary analysis: automated closed loop system versus non‐automated system.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Total weaning duration by study population	16	1246	Mean Difference (IV, Random, 95% CI)	‐0.36 [‐0.59, ‐0.14]
1.1 Mixed and medical ICU population	9	542	Mean Difference (IV, Random, 95% CI)	‐0.55 [1.00, ‐0.10]
1.2 Surgical ICU population	7	704	Mean Difference (IV, Random, 95% CI)	‐0.07 [‐0.18, 0.04]
2 Total weaning duration by automated system	16	1246	Mean Difference (IV, Random, 95% CI)	‐0.36 [‐0.59, ‐0.14]
2.1 Smartcare/PS	7	744	Mean Difference (IV, Random, 95% CI)	‐0.33 [‐0.58, ‐0.09]
2.2 ASV	4	295	Mean Difference (IV, Random, 95% CI)	‐0.03 [‐0.11, 0.05]
2.3 Other	5	207	Mean Difference (IV, Random, 95% CI)	‐0.54 [‐1.17, 0.08]
3 Total weaning duration by non‐automated strategy (control arm)	16	1246	Mean Difference (IV, Random, 95% CI)	‐0.36 [‐0.59, ‐0.14]
3.1 usual care	5	238	Mean Difference (IV, Random, 95% CI)	‐0.46 [‐0.83, ‐0.10]
3.2 protocolized weaning (non‐automated)	11	1008	Mean Difference (IV, Random, 95% CI)	‐0.32 [‐0.59, ‐0.06]
4 Randomization to first extubation	11	1039	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐0.34, ‐0.05]
5 Ventilation duration by study population	14	1248	Mean Difference (IV, Random, 95% CI)	‐0.11 [‐0.18, ‐0.03]
5.1 Mixed and medical ICU population	9	777	Mean Difference (IV, Random, 95% CI)	‐0.14 [‐0.25, ‐0.02]
5.2 Surgical ICU population	5	471	Mean Difference (IV, Random, 95% CI)	‐0.12 [‐0.26, 0.01]
6 Ventilation duration of by automated system	11	1002	Mean Difference (IV, Random, 95% CI)	‐0.09 [‐0.18, ‐0.00]
6.1 Smartcare/PS	6	706	Mean Difference (IV, Random, 95% CI)	‐0.17 [‐0.31, ‐0.03]
6.2 ASV	5	296	Mean Difference (IV, Random, 95% CI)	‐0.04 [‐0.15, 0.07]
7 Ventilation duration of by non‐automated strategy (control arm)	14	1248	Mean Difference (IV, Random, 95% CI)	‐0.11 [‐0.18, ‐0.03]
7.1 Usual care	2	132	Mean Difference (IV, Random, 95% CI)	‐0.11 [‐0.39, 0.17]
7.2 Protocolized weaning (non‐automated)	12	1116	Mean Difference (IV, Random, 95% CI)	‐0.11 [‐0.19, ‐0.03]
8 Intubation to randomization	10	631	Mean Difference (IV, Random, 95% CI)	‐0.04 [‐0.14, 0.05]
9 Secondary outcome 5.1: mortality	12	1128	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.83, 1.31]
9.1 ICU mortality	6	254	Risk Ratio (M‐H, Random, 95% CI)	1.23 [0.58, 2.60]
9.2 30 day mortality	2	397	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.75, 1.75]
9.3 Hospital	4	477	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.62, 1.45]
10 Hospital length of stay	7	749	Mean Difference (IV, Random, 95% CI)	‐0.10 [‐0.21, 0.02]
11 ICU length of stay by ICU population	13	1339	Mean Difference (IV, Random, 95% CI)	‐0.08 [‐0.16, 0.00]
11.1 Mixed or medical ICU population	8	760	Mean Difference (IV, Random, 95% CI)	‐0.18 [‐0.32, ‐0.04]
11.2 Surgical ICU population	5	579	Mean Difference (IV, Random, 95% CI)	0.02 [‐0.02, 0.06]
12 ICU length of stay by automated system	12	1131	Mean Difference (IV, Random, 95% CI)	‐0.10 [‐0.19, ‐0.01]
12.1 Smartcare/PS	6	707	Mean Difference (IV, Random, 95% CI)	‐0.26 [‐0.43, ‐0.09]
12.2 ASV	6	424	Mean Difference (IV, Random, 95% CI)	0.02 [‐0.02, 0.06]
13 Reintubation	13	1081	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.61, 1.05]
13.1 Usual care	4	182	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.27, 1.88]
13.2 Protocolized weaning (non‐automated)	9	899	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.61, 1.07]
14 Self‐extubation	9	813	Risk Ratio (M‐H, Random, 95% CI)	1.24 [0.58, 2.67]
15 Non invasive ventilation	12	1314	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.53, 1.02]
16 Prolonged mechanical ventilation	7	753	Risk Ratio (M‐H, Random, 95% CI)	0.51 [0.27, 0.95]
17 Tracheostomy	9	962	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.50, 0.90]