Toward less sedation in the intensive care unit: A

prospective observational study

Diamantino R Salgado ND, NSc
a
, Raphael Favory ND, PhD
a
, Nateus Coulart
ND
a
, Serge Brimioulle ND, PhD
a
and ]eanLouis vincent ND, PhD
,

a
Department of !ntensive Care, Erasme Hospital, Universit Libre de Bruxelles, 1070
Brussels, Belgium

Available online 26 ]anuary 2011.

Abstract
Purpose
Excessive sedation is associated with prolonged mechanical ventilation and longer
intensive care unit (!CU) and hospital stays. We evaluated the feasibility of using
minimal sedation in the !CU.
Nethods
Prospective observational study in a university hospital 34bed medicosurgical
department of intensive care. All adult patients who stayed in the !CU for more than 12
hours over a 2month period were included. !ntensive care unit admission diagnoses,
severity scores, use of sedatives and/or opiates, duration of mechanical ventilation,
length of !CU stay, and 28day mortality were recorded for each patient.
Results
Of the 33S patients (median age, 61 years) admitted during the study period, 142
(42) received some sedation, most commonly with midazolam and propofol. Sedative
agents were administered predominantly for short periods of time (only 10 of patients
received sedation for >24 hours). One hundred fiftyfive patients (46) received
mechanical ventilation, generating 1S 240 hours of mechanical ventilation, of these,
only 2333 (20) hours were accompanied by a continuous sedative infusion. Self
extubation occurred in 6 patients, but only 1 needed reintubation.
onclusions
!n a mixed medicalsurgical !CU, minimal use of continuous sedation seems feasible
without apparent adverse effects.


Reaction:
! think the study is true, because by using sedation to a patient it lessen its pain, but
his body will be more dependent to the sedation and its extending the patient to adopt
the pain towards his recovery.






]ournal
in
NCN 104








Submitted by:
]aycee Nallari Submitted to:
Nrs. Shiela Torres
R.N NAN