Daily Interruption of Sedatives to Improve Outcomes in Critically Ill Patients

Author(s):  
Christopher G. Hughes ◽  
Pratik P. Pandharipande ◽  
Timothy D. Girard
Author(s):  
Ulrich Schmidt ◽  
Zeb McMillan

This chapter provides a summary of the landmark study known as a protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomized trial. Can duration of mechanical ventilation be reduced with a protocol of no sedation versus daily interruption of sedation? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. Understanding that not all patients receiving mechanical ventilation require sedation is an important first step to determining the best regimen.


Author(s):  
David Stahl

This chapter provides a summary of a landmark study in critical care medicine. Does the daily interruption of continuous sedative infusions in critically ill patients receiving mechanical ventilation decrease the duration of mechanical ventilation and the duration of stay in the intensive care unit (ICU)? This chapter describes the study designed to answer that question including funding, study location, patient population, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant context and studies, discusses implications, and concludes with a relevant clinical case. This was the first randomized-controlled trial to demonstrate that daily sedation interruption for mechanically ventilated medical ICU patients is safe and may reduce the duration of mechanical ventilation and length of stay in the ICU.


2000 ◽  
Vol 342 (20) ◽  
pp. 1471-1477 ◽  
Author(s):  
John P. Kress ◽  
Anne S. Pohlman ◽  
Michael F. O'Connor ◽  
Jesse B. Hall

2012 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Elizabeth Berry ◽  
Heather Zecca

The continuous infusion of sedative agents is often necessary for critically ill patients. However, it has been associated with several disadvantages. Numerous interventions to reduce these risks have been evaluated, including the practice of interrupting sedative infusions on a daily basis. A literature search was conducted, and 7 studies were reviewed to evaluate the safety and effectiveness of daily interruption of sedative infusions and its outcomes. The implementation of daily sedation interruptions was suggested to minimize multiple complications associated with continuous sedative infusions and was not associated with intensive care–related complications or long-term psychological effects. Additional studies have revealed perceived barriers to the implementation of daily sedation interruptions. Further randomized controlled trials enrolling larger, more diverse samples are needed to provide more evidence regarding the safety and effectiveness of this intervention.


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