Weaning and Extubation Assisted With Conversational Hypnosis: A Systematic Review

Abstract Background: Patients admitted in intensive care units often receive mechanical ventilation. Prior to extubation, the weaning process could be a major cause of dyspnea and anxiety in awake intubated patients. Hypnotherapy is nowadays commonly used to manage anxiety and pain. Our hypothesis is that hypnosis would decrease stress during the weaning and extubation process.Methods: This systematic review follows PRISMA Guidelines and was registered in PROSPERO (CRD42020171445). Web of Science, MEDLINE and Cochrane Central Register of Controlled Trials databases were searched between 02/23/20 and 03/11/20. We included all types of interventional trials assessing hypnotherapy for intubated patients whom were undergoing the weaning process or extubation. Two of the authors independently screened studies, extracted data and assessed risk of bias from identified trials.Results: One study fulfilled our selection. This case series included 2 patients. Eleven sessions were completed. Hypnotherapy decreased anxiety during the weaning process from a median of 1 point (Interquartile Range: 1.0-2.5). Increase in oxygen saturation is also reported. There was no evidence of neither an anxiety reduction or an oxygen saturation improvement. This is due to the scarcity of publication and the methodological design of the one selected study.Conclusions: We cannot conclude whether or not hypnosis could be recommended in the weaning process of intubated patients. Further studies are needed to assess hypnosis effects.