Sedation Linked to Longer Stay in ICU
FRIDAY Jan. 29, 2010 -- Critically ill patients in intensive care who aren't sedated require fewer days on mechanical ventilation and spend less time in the intensive care unit than those who are sedated, new research suggests.
The Danish study included 113 critically ill adult patients expected to need mechanical ventilation for more than 24 hours. The patients were randomly assigned to receive no sedation or sedation (20 milligrams per milliliter (mg/mL) propofol for 48 hours, 1 mg/mL midazolam thereafter) with daily interruption until awake. They were followed for 28 days.
The 55 patients who were not sedated had more days without ventilation than the 58 patients who were sedated (13.8 days versus 9.6 days, respectively) and spent less time in the intensive care unit (13.1 days versus 22.8 days, respectively).
"Findings from our study show that in critically ill patients receiving mechanical ventilation, a protocol of no sedation significantly increased the number of days without ventilation in a 28-day period compared with daily interruption of sedation," wrote the researchers at the Odense University Hospital, University of Southern Denmark.
"Use of no sedation was also associated with a significant reduction in the length of stay in the intensive care unit and in hospital," they added. "Results from this single-center study suggest that a strategy of no sedation is promising, but a multicenter trial is needed to show that the benefits of this strategy can be reproduced in other facilities."
The study findings were released online Jan. 28 in advance of publication in an upcoming print issue of The Lancet.
The American College of Chest Physicians has more about mechanical ventilation.
Posted: January 2010
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