Introduction
Mechanical ventilation was a path-breaking intervention in management of critically ill patients in the 19thcentury. Over the years, mechanical ventilation has revolutionised critical care management and saved many lives. However, prolonged mechanical ventilation has its own complications.[1] Weaning from ventilator is considered to be a blend of art and science. The steps in the process include assessing the readiness for weaning, giving a spontaneous breath trial (SBT) and finally the decision to extubate.[1,2] These steps constitute 40% of the time a patient spends on mechanical ventilation, and delay in any of them will result in an overall delay in the process of weaning.[3] Attempts have been made to introduce objectivity in the process by introduction of protocols in pursuit of hastening the process of liberation from mechanical ventilation. Most of the studies have been conducted in resource-rich settings and have shown significant improvement in adherence to evidence-based protocols after their introduction and reinforcement via continuous education of the physicians, which has led to a higher weaning success.[4-6] There is a scant literature on adherence to evidence-based protocols of weaning in resource- limited settings and effect of educational interventions on the same. Current evidence suggests the need for weaning protocols to account for the complexities of social and cultural environment in which they are to be implemented, particularly in resource-limited settings. [7] We conducted this study to assess the current weaning practices and impact of implementation of evidence-based weaning protocol in a high-burden tertiary care ICU setting.