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2023, Number 2

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Med Crit 2023; 37 (2)

Cardiac events and desaturation in patients under invasive mechanical ventilation with continuous intravenous sedation vs daily interruption of sedation

Mendoza MV, Pizaña DA, Alva ANV, Jaramillo SAE
Full text How to cite this article 10.35366/110440

DOI

DOI: 10.35366/110440
URL: https://dx.doi.org/10.35366/110440

Language: Spanish
References: 12
Page: 78-81
PDF size: 162.15 Kb.


Key words:

sedation, daily interruption of sedation, invasive mechanical ventilation, safety.

ABSTRACT

Introduction: sedation in the critically patient requiring mechanical ventilation is an important intervention used to provide safety and comfort to the patient. Currently, the management of critically ill patients is based on the ABCDEF bundle (A [assess]: prevent and manage pain. B [both]: protocols for daily interruption of sedation and spontaneous breathing protocol. C [choice]: of analgesia and sedation. D [delirium]: assess, prevent and manage delirium. E [early]: exercise and early mobility. F [family]: inclusion and empowerment) which recommends daily interruption of sedation and a daily spontaneous breathing protocol, it has shown improvement in clinical outcomes (days on mechanical ventilation, delirium). This contrasts with the frequent management of continuous intravenous sedation. Therefore, in this study the safety of these two forms of sedation (daily interruption vs continuous intravenous) will be compared. Objective: to compare the incidence of cardiovascular events and desaturation between a protocol of daily interruption of sedation in patients with invasive mechanical ventilation versus continuous intravenous sedation in patients with invasive mechanical ventilation. Material and methods: retrospective comparative descriptive study. Results: there was no statistically significant difference in the incidence of cardiac events and desaturation between patients with continuous intravenous sedation and daily sedation interruption protocol. Conclusion: continuous intravenous sedation and daily interruption of sedation protocol are equally safe in critically ill patients.


REFERENCES

  1. Vagionas D, Vasileiadis I, Rovina N, Alevrakis E, Koutsoukou A, Koulouris N. Daily sedation interruption and mechanical ventilation weaning: a literature review. Anaesthesiol Intensive Ther. 2019;51(5):380-389.

  2. American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharmacists, American College of Chest Physicians. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Am J Health Syst Pharm. 2002;59(2):150-178.

  3. Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342(20):1471-1477.

  4. Strom T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet. 2010;375(9713):475-480.

  5. Mehta S, Burry L, Cook D, Fergusson D, Steinberg M, Granton J, et al. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA. 2012;308(19):1985-1992.

  6. Nassar Junior AP, Park M. Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial. Ann Intensive Care. 2014;4:14.

  7. Girard TD, Kress JP, Fuchs BD, Thomason JW, Schweickert WD, Pun BT, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet. 2008;371(9607):126-134.

  8. de Wit M, Gennings C, Jenvey WI, Epstein SK. Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Crit Care. 2008;12(3):R70.

  9. Yiliaz C, Kelebek Girgin N, Ozdemir N, Kutlay O. The effect of nursing-implemented sedation on the duration of mechanical ventilation in the ICU. Ulus Travma Acil Cerrahi Derg. 2010;16(6):521-526.

  10. Kayir S, Ulusoy H, Dogan G. The effect of daily sedation-weaning application on morbidity and mortality in Intensive Care Unit Patients. Cureus. 2018;10(1):e2062.

  11. Anifantaki S, Prinianakis G, Vitsaksaki E, Katsouli V, Mari S, Symianakis A, et al. Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial. J Adv Nurs. 2009;65(5):1054-1060.

  12. Weisbrodt L, McKinley S, Marshall AP, Cole L, Seppelt IM, Delaney A. Daily interruption of sedation in patients receiving mechanical ventilation. Am J Crit Care. 2011;20(4):e90-e98.




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Med Crit. 2023;37