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Quality improvement
Protocol-directed sedation did not reduce duration of mechanical ventilation or hospital stay in ICU patients

https://doi.org/10.1136/ebn.11.4.124

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    T K Bucknall

    Dr T K Bucknall, Deakin University, Burwood, Victoria, Australia; tracey.bucknall@deakin.edu.au

    QUESTION

    Does protocol-directed sedation reduce duration of mechanical ventilation in intensive care units (ICUs)?

    METHODS

    Design:

    randomised controlled trial.

    Allocation:

    concealed.

    Blinding:

    blinded {data collectors, outcome assessors, and data analysts}.*

    Follow-up period:

    duration of hospital stay.

    Setting:

    a 24-bed, university-affiliated, mixed medical-surgical-trauma ICU in Australia.

    Patients:

    316 adults who were mechanically ventilated. Patients admitted after cardiac surgery or who were previously enrolled in the study were excluded.

    Intervention:

    155 patients were allocated to the sedation protocol, which specified medications to be prescribed to achieve a Sedation Agitation Scale (SAS) target. Nurses determined sedation and analgesia type, dose, and method of administration to provide optimal care consistent with the protocol. 161 patients were allocated to usual sedation practice, which …

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    Footnotes

    • Source of funding: in part, Abbott Australasia Pty Ltd and Australian College of Critical Care Nurses.