Journal article
Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients
Critical care medicine, Vol.32(6), pp.1272-1276
2004
DOI: 10.1097/01.CCM.0000127263.54807.79
PMID: 15187505
Abstract
Objective: In critically ill patients receiving mechanical ventilation, daily interruption of sedative infusions decreases duration of mechanical ventilation and intensive care unit length of stay. Whether this sedation strategy reduces the incidence of complications commonly associated with critical illness is not known.
Design: Blinded, retrospective chart review.
Setting: University-based hospital in Chicago, IL.
Patients: One hundred twenty-eight patients receiving mechanical ventilation and continuous infusions of sedative drugs in a medical intensive care unit.
Interventions: None.
Measurements and main results: We performed a blinded, retrospective evaluation of the database from our previous trial of 128 patients randomized to daily interruption of sedative infusions vs. sedation as directed by the medical intensive care unit team without this strategy. Seven distinct complications associated with mechanical ventilation and critical illness were identified: a) ventilator-associated pneumonia; b) upper gastrointestinal hemorrhage; c) bacteremia; d) barotrauma; e) venous thromboembolic disease; and f) cholestasis or g) sinusitis requiring surgical intervention. The incidence of complications was evaluated for each patient's hospital course. One hundred twenty-six of 128 charts were available for review. Patients undergoing daily interruption of sedative infusions experienced 13 complications (2.8%) vs. 26 (6.2%) in those subjected to conventional sedation techniques (p =.04).
Conclusions: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation reduces intensive care unit length of stay and, in turn, decreases the incidence of complications of critical illness associated with prolonged intubation and mechanical ventilation.
Details
- Title: Subtitle
- Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients
- Creators
- William D SCHWEICKERT - Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, United StatesBrian K GEHLBACH - Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, United StatesAnne S POHLMAN - Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, United StatesJesse B HALL - Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, United StatesJohn P KRESS - Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, United States
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.32(6), pp.1272-1276
- Publisher
- Lippincott; Hagerstown, MD
- DOI
- 10.1097/01.CCM.0000127263.54807.79
- PMID
- 15187505
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Language
- English
- Date published
- 2004
- Academic Unit
- Neurology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984020988902771
Metrics
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