© 2000 Evidence-Based Nursing
Daily interruption of sedative infusions reduced duration of mechanical ventilation and intensive care unit stay in critically ill patients
Kress JP, Pohlman AS, O'Connor MF, et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000 May 18;342:1471–7.
QUESTION: Does daily interruption of sedative infusions in critically ill patients reduce the duration of mechanical ventilation and length of stay in the intensive care unit (ICU) and in hospital?
Randomised {allocation concealed}*, blinded {patients and clinicians}* controlled trial with follow up to hospital discharge.
A medical ICU in Chicago, Illinois, USA.
150 patients who were intubated and receiving mechanical ventilation and who required sedation by continuous intravenous (IV) infusion (eg, patients who showed agitation or discomfort after recovering from drugs used to facilitate intubation). Exclusion criteria were pregnancy, transfer from an outside institution where sedatives had already been given, and admission after resuscitation from cardiac arrest. 128 patients (53% women) were included in the final analysis (22 patients died or were extubated on the first or second day in the ICU).
75 patients were allocated to daily interruption of sedative infusion beginning 48 hours after enrolment; infusions were interrupted until the patient was awake and could follow instructions or became uncomfortable or agitated. 75 patients were allocated to continuous infusion of sedatives, with interruption only at the discretion
Clinical Educator, Critical Care Trauma Centre London Health Sciences Centre London, Ontario, Canada
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