No-Sedation Protocol Shown to Reduce Ventilation Time
Single-center study of critically-ill patients also associates protocol with shorter ICU stays
FRIDAY, Jan. 29 (HealthDay News) -- In critically ill patients receiving mechanical ventilation, a protocol of no sedation may reduce the number of days that ventilation is required, according to a study published online Jan. 29 in The Lancet.
Thomas Strom, M.D., of the Odense University Hospital in Denmark, and colleagues randomly assigned 140 critically ill adult patients to receive either no sedation or sedation with 20 mg/mL propofol for 48 hours followed by 1 mg/mL midazolam with daily interruption until awake.
The researchers found that the no-sedation protocol was associated with a significantly greater mean number of ventilation-free days than the sedation protocol (13.8 versus 9.6). They also found that the no-sedation protocol was associated with a shorter intensive care unit stay and shorter hospital stay for the first 30 days studied (hazard ratios, 1.86 and 3.57, respectively).
"Results from this single-centre 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 authors conclude. "A multicenter study should be powered to detect outcome measures from our study -- ventilation time, and length of stay in the intensive care unit and in hospital -- and should use the confusion assessment method for the intensive care unit to detect silent forms of delirium."