- Paper Report
- Open Access
Interupted sedation reduces ITU length of stay
- Mike Grocott1
© Current Science Ltd 2000
- Published: 27 June 2000
- Mechanical ventilation
Continuous sedative infusions are commonly employed in many ICUs; however, their use has been associated with prolonged duration of mechanical ventilation and length of ICU and hospital stay. The study was designed to establish whether the daily interruption of continuous sedative infusions could decrease ICU stay, hospital stay and duration of mechanical ventilation.
A randomised controlled trial of 128 mechanically ventilated adults in a medical ICU
Intervention group had sedative infusions stopped until the patient awoke
Control group had sedative infusions managed according to the attending physicians usual practise
Patients were further randomly assigned to receive either midazolam with morphine or propofol with morphine
The intervention group had a reduced median duration of mechanical ventilation days (4.9 vs 7.1 days; P = 0.004) and reduced median length of stay in the ICU (6.4 vs 9.9; P = 0.02) when compared with the control group. Fewer of the patients in the intervention group had diagnostic tests to assess mental status (6/68 vs 16/60; P = 0.02). Daily waking andassesment seems to have reduced the requirement for special tests of brainfunction such as CT. Complications occurred less commonly in the intervention group (3/68 vs 4/60; P = 0.88).Patients in the intervention group sedated with midazolam received a lower total dose of midazolam (P = 0.05) and morphine (P= 0.009) than those in the control group. No comparable difference was observed in patients sedated with propafol.
See accompanying editorial by Heffner et al,New Engl J Med 2000, 342:1520-1522