Jouvet 2013.

Methods	Single‐centre, randomized controlled trial
Participants	Setting: pediatric ICU, Montreal, Canada Inclusion criteria: age between 2 and 18 years; body weight ≥ 15 kg; mechanically ventilated > 12 hours; availability of Evita XL respirator with SmartCare/PSTM ; fulfilling weaning criteria (able to breathe spontaneously; no vasopressor or inotropic medication; FiO2 ≤ 60% with pulse oximetry ≥ 95%; PEEP ≤ 8 cm H2O; PaCO2 < 70 mmHg; endotracheal tube leakage ≤ 20%) Exclusion criteria: chronic respiratory insufficiency due to neurological, neuromuscular or lung disease before ICU admission; primary pulmonary hypertension; cyanotic congenital heart disease with unrepaired/palliated right to left intracardiac shunt; not expected to survive; decision to withdraw care; no parental consent Participant numbers: 30 randomly assigned; 30 analysed
Interventions	Automated weaning protocol using SmartCare/PS Standard weaning practice without formal guidelines (detail not reported)
Outcomes	Time from randomization to first extubation Weaning failure (resuming invasive or noninvasive mechanical ventilation within 48 hours) Failure to wean within 28 days Total duration of mechanical ventilation (from intubation to extubation) ICU and hospital length of stay
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	30 sealed envelopes contained control or SmartCare group sheet of paper (15 each) in a random manner and numbered from 1 to 30. After inclusion of a participant, the research assistant took the envelope n°1, 2, etc (author communication)
Allocation concealment (selection bias)	Low risk	Opaque sealed envelopes were used
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Personnel were unblinded and extubation decision was made by attending clinicians in both groups
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	This was not reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	Recruitment and attrition were reported
Selective reporting (reporting bias)	Low risk	Protocol was registered as NCT00678912 and outcomes were reported
Other bias	Low risk	None was apparent