Circumventing Sedation Reduces Mechanical Ventilation Time
|
By HospiMedica International staff writers Posted on 05 Feb 2010 |
|
A new study shows that avoiding sedation in ventilated patients shortens the duration of mechanical ventilation, intensive care unit (ICU) stay, and hospitalization time.
Researchers at Odense University Hospital (Denmark) randomized 140 mechanically ventilated patients to either an interrupted sedation group--with the sedative infusion stopped every morning and the patient awakened--or to a no-sedation group. All patients received intravenous (IV) morphine boluses as needed and IV haloperidol for delirium, but no physical restraints were used. If possible, the patients were sat in a chair each day. Excluding those patients who died or were extubated within less than 48 hours of ventilation, 55 patients in the no-sedation group and 58 in the sedation group remained for intent-to-treat analysis.
The results showed that after 4 weeks, the sedation group had significantly more days on mechanical ventilation the no-sedation group ((13.8 versus 9.6 days, respectively). In addition, the sedated patients averaged more days in the ICU (22.8 versus 13.1 days) and longer overall hospital stays (58 versus 34 days); however, once patients were in the ICU for longer than 30 days, sedation no longer affected total ICU length of stay. The researchers observed no significant differences between groups in accidental removal of the endotracheal tube, need for brain imaging, or incidence of ventilator-associated pneumonia. Overall, 18% of patients in the no-sedation group could not tolerate it and had to receive continuous sedation on more than two occasions, typically to permit sufficient oxygenation in a severe acute respiratory distress syndrome (ARDS) episode. The only negative impact of the no-sedation strategy appeared to be an increase in agitated delirium (20% versus 7%) resulting in more frequent use of haloperidol. The study was published in the February 6, 2010, issue of the Lancet.
"I think most importantly one needs to evaluate the patients' needs each day; make sure they are comfortable and free of pain and only give sedation as a last escape,” said lead author Thomas Strøm, M.D., of the department of anesthesia and intensive care medicine.
Related Links:
Odense University Hospital
Researchers at Odense University Hospital (Denmark) randomized 140 mechanically ventilated patients to either an interrupted sedation group--with the sedative infusion stopped every morning and the patient awakened--or to a no-sedation group. All patients received intravenous (IV) morphine boluses as needed and IV haloperidol for delirium, but no physical restraints were used. If possible, the patients were sat in a chair each day. Excluding those patients who died or were extubated within less than 48 hours of ventilation, 55 patients in the no-sedation group and 58 in the sedation group remained for intent-to-treat analysis.
The results showed that after 4 weeks, the sedation group had significantly more days on mechanical ventilation the no-sedation group ((13.8 versus 9.6 days, respectively). In addition, the sedated patients averaged more days in the ICU (22.8 versus 13.1 days) and longer overall hospital stays (58 versus 34 days); however, once patients were in the ICU for longer than 30 days, sedation no longer affected total ICU length of stay. The researchers observed no significant differences between groups in accidental removal of the endotracheal tube, need for brain imaging, or incidence of ventilator-associated pneumonia. Overall, 18% of patients in the no-sedation group could not tolerate it and had to receive continuous sedation on more than two occasions, typically to permit sufficient oxygenation in a severe acute respiratory distress syndrome (ARDS) episode. The only negative impact of the no-sedation strategy appeared to be an increase in agitated delirium (20% versus 7%) resulting in more frequent use of haloperidol. The study was published in the February 6, 2010, issue of the Lancet.
"I think most importantly one needs to evaluate the patients' needs each day; make sure they are comfortable and free of pain and only give sedation as a last escape,” said lead author Thomas Strøm, M.D., of the department of anesthesia and intensive care medicine.
Related Links:
Odense University Hospital
Gold Member
12-Channel ECG
CM1200B
Gold Member
SARS‑CoV‑2/Flu A/Flu B/RSV Sample-To-Answer Test
SARS‑CoV‑2/Flu A/Flu B/RSV Cartridge (CE-IVD)
X-Ray Generator
Advantage Plus Generators
POC Respiratory/Sore Throat Test
BIOFIRE SPOTFIRE (R/ST) Panel
Latest Critical Care News
- Smartphone Heart Rhythm App Reduces Unnecessary Cardioversion Procedures
- Handheld ECG Algorithm Shows Promise for At-Home Heart Attack Risk Assessment
- Bedside CSF Monitor Detects Early Infection in Fluid Drains
- Wearable Ultrasound Patch Noninvasively Paces Heart to Stabilize Arrhythmias
- New Practice Guidance Supports Prostatic Artery Embolization for BPH Symptoms
- AI ECG Tool Detects Cardiac Amyloidosis for Early Screening
- Cuffless Wearable Enables Continuous Blood Pressure Monitoring for Hypertension Care
- AI-Guided System Supports Cardiac Ultrasound Training on Cart-Based Systems
- AI ECG Index Tracks Pubertal Maturation in Children and Adolescents
- Noninvasive AI Tool Enables Pressure-Guided Heart Failure Management
- Regenerative Therapies Aim to Support Recovery After Traumatic Brain Injury
- Ring-Type Cuffless Monitor Becomes First Added to Official Hypertension Guidelines
- “Intelligent Tattoo” Method Detects Early Melanoma Signals
- Implantable Wireless Light Device Advances Bladder Cancer Treatment
- Reusable Intermittent Catheters Reduce Antibiotic Use Without Increasing Urinary Tract Infections
- Smart Wristband Technology Detects Cardiac Arrest and Alerts Responders
Channels
Artificial Intelligence
view channel
AI Platform Supports Noninvasive Remote Hemodynamic Monitoring in Heart Failure
Heart failure remains a leading cause of hospitalization in adults over 65, affecting more than 6.7 million people in the U.S. Clinicians often lose visibility into hemodynamic deterioration once patients... Read more
AI Tool Predicts Unplanned Care and Symptom Burden in Cancer Survivors
Unplanned emergency visits and hospitalizations remain common in cancer survivorship, when routine clinical contact often tapers while new symptoms emerge. These events reflect unmet needs and disrupt... Read more
Surgical Techniques
view channel
New CAR T-Cell Therapy Enables Transplants in Hard-to-Match Kidney Patients
Highly sensitized kidney transplant candidates have extremely high levels of anti-donor antibodies that block matching and prolong dialysis. These patients face long wait times and increased morbidity... Read more
CE-Marked Ultrasonic Shears Streamline Breast and Thyroid Surgery
Thyroid and breast surgeries are often performed in confined anatomical spaces near critical structures, making precise dissection and controlled thermal management essential. As the global disease burden... Read more
Patient Care
view channel
AI Avatar Doctor Improves Patient Understanding Before Radiotherapy
Radiation oncology consultations require patients to grasp complex concepts quickly, yet anxiety and information overload often undermine understanding and informed consent. Poor comprehension can also... Read more
Wearable Sleep Data Predict Adherence to Pulmonary Rehabilitation
Chronic obstructive pulmonary disease (COPD) is a long-term lung disorder that makes breathing difficult and often disturbs sleep, reducing energy for daily activities. Limited engagement in pulmonary... Read more
Health IT
view channel
AI-Native EHR Achieves EU Medical Device Certification
InterSystems (Boston, MA, USA) announced that its IntelliCare electronic health record (EHR) solutions have been certified as Class IIa medical devices under the European Union Medical Device Regulation... Read more
EHR-Integrated Screening Workflow Detects Cognitive Impairment at Admission
Cognitive impairment involves difficulties with thinking, learning, memory, and decision-making, and is more common in older adults. In U.S. hospitals, more than 40% of admitted older adults have dementia,... Read more
Point of Care
view channel
Portable MRI System Accelerates Emergency Brain Imaging and Triage
Emergency departments frequently face delays accessing conventional magnetic resonance imaging (MRI) for patients with suspected neurological emergencies. Such waits can slow triage, prolong boarding,... Read more
Point-of-Care Viscoelastic Testing System Supports Obstetric Bleeding Management
HemoSonics (Durham, NC, USA) announced on May 5, 2026 that the company's Quantra Hemostasis System for Obstetric Procedures won Silver in the 2026 Edison Awards in the Women’s Health and Reproductive Innovations... Read more
Business
view channel
Endologix Adds FDA-Cleared Peripheral Thrombectomy System
Endologix (Santa Rosa, CA, USA) has acquired the Pounce Thrombectomy System from Surmodics, with the transaction closing on May 18, 2026. The FDA-cleared system is indicated for the non-surgical removal... Read more
