Effect of a nursing-implemented sedation protocol on weaning outcome*
| Autor: | Andrés Esteban, Niall D. Ferguson, Juana Gallardo-Murillo, S. Arias-Rivera, Rosa Santos-Díaz, Fernando Frutos-Vivar, R. Sánchez-Izquierdo, Maria del Mar Sánchez-Sánchez |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
Resuscitation medicine.drug_class Midazolam Sedation medicine.medical_treatment Conscious Sedation Kaplan-Meier Estimate Critical Care and Intensive Care Medicine Intensive care medicine Humans Hypnotics and Sedatives Hospital Mortality Prospective Studies Prospective cohort study Aged Pain Measurement Mechanical ventilation business.industry Length of Stay Intensive Care Units Anesthesia Sedative Breathing Female medicine.symptom business Ventilator Weaning medicine.drug |
| Zdroj: | Critical Care Medicine. 36:2054-2060 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/ccm.0b013e31817bfd60 |
| Popis: | edative and analgesic medica-tions are commonly used incritically ill patients, especiallyin those who are mechanicallyventilated (1). The need for continuousadministration of sedatives has been as-sociated with longer durations of me-chanical ventilation and stay in the in-tensive care unit (ICU) (2). Severalapproaches, such as daily interruptionof sedatives infusions (3), or the imple-mentation of a sedation protocol to ad-just the sedatives to a target sedationlevel (4–9), have been proposed toshorten the time to arousal and, as aconsequence, the duration of mechani-cal ventilation.Several studies have shown significantpositive effects of a sedation protocol onduration of mechanical ventilation (4–8),although these findings are not universal(9). Some of these studies have reporteddifferences in the duration of mechanicalventilation between survivors and non-survivors and between tracheostomizedand nontracheostomized patients; itcould be possible that mismatching ofthese subgroups between interventiongroups influenced the final results. Ourobjective was to determine the effect ofthe implementation of a sedation proto-col, including only mechanically venti-lated patients who were ready to wean.Our hypothesis was that if the nursingstaff could manage the sedation of thesepatients, then they would be more awakewhen they met criteria to perform a spon-taneous breathing trial and, therefore,could be extubated earlier. The primaryoutcome was the duration of intubation.Some of the results of this study havebeen reported previously in the form ofan abstract (10). |
| Databáze: | OpenAIRE |
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