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Evid Based Nurs 3:121 doi:10.1136/ebn.3.4.121
  • Treatment

Daily interruption of sedative infusions reduced duration of mechanical ventilation and intensive care unit stay in critically ill patients


 
 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?

Design

Randomised {allocation concealed}*, blinded {patients and clinicians}* controlled trial with follow up to hospital discharge.

Setting

A medical ICU in Chicago, Illinois, USA.

Patients

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).

Intervention

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 …

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