Differently, results from paediatric trials implementing ventilator weaning protocols have been less convincing so far. In a large multicenter trial, performed in ten PICUs in North America by the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, there was no difference between groups randomized to either automated ventilator-adjusted volume support protocol, physician directed pressure support weaning, or no protocol [18]. In fact, protocol-driven programs were equivalent to no protocol regarding weaning time from randomization to successful extubation as well as the extubation failure rate [