Effect of daily sedation interruption and the patient’s outcome who are under mechanical ventilation: A mini systematic review

Konstantina Satolia ,Dimitrios Alefragkis

doi:10.32553/ijmsdr.v4i12.714

Abstract

Continuous administration of sedatives to the intensive care unit may increase the duration of mechanical ventilation, extend the patient's stay in the intensive care unit, and, subsequently, to the hospital. The objective was to improve the outcome of intubated patients in terms of the total duration of mechanical ventilation, the stay of these patients in the intensive care unit (ICU), and their mortality. This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted in October 2020. Articles were searched in the PubMed and Cochrane Library online databases. Data were extracted from all included research studies and analyzed thematically. The search duration was between 2008 and 2018. The studies do not document statistically significant differences with the parameters under study (total duration of mechanical ventilation, the total length of stay in the intensive care unit (ICU), and mortality), for a better outcome of intubated patients. The application of the daily sedation interruption (DSI) did not appear to affect the duration of Mechanical Ventilation, the length of stay in the ICU, and mortality in intubated patients. Keywords: Daily sedation interruption, intubated patients

Highlights

Ventilated patients often receive sedative drugs to manage anxiety, agitation, and ventilator dyssynchrony
A literature search was conducted in October 2020 by both reviewers with search duration between 2008 and 2018, to identify research studies about the effect of daily sedation interruption and the patient's outcome who are under mechanical ventilation
One group (Group P) which consisted of twentyfive patients received daily sedation interruption protocol and the other group (Group N) received nursing-implemented sedation protocol

Summary

Introduction

Ventilated patients often receive sedative drugs to manage anxiety, agitation, and ventilator dyssynchrony. All intubated patients receive medication to relieve pain and anxiety.[1,2] Commonly combinations of sedatives and analgesics are used. The most common substances are benzodiazepines such as Midazolam and opioids such as Propofol, Fentanyl, and Remifentanil.[3,4] Doses for these classes of drugs are set according to the desired depth of sedation for patient safety. Deeper sedation is required in patients with a critical illness such as cerebral edema, severe respiratory failure with difficulty ventilating.[5]

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Discussion

Conclusion