Effects of different regimens of sedation on mechanically ventilated patients

Abstract

Background: Up to one-third of intensive care unit (ICU) patients worldwide undergo mechanical ventilation. These patients frequently require analgesics and sedatives-potent medications with clear benefits and significant side effects. Objective: The current study intended to assess the effects of application of different regimens of sedation on mechanically ventilated patients regarding the length of ventilator days, length of hospital stay, multiple organ dysfunctions, ventilator-associated pneumonia (VAP), and mortality. Methods: One hundred adult patients who are intubated for any cause and attached to mechanical ventilation for more than 24 h will be included in this study. Drugs used for sedation were propofol and midazolam. Patients underwent history taking, clinical examination, laboratory investigations, chest X-ray, and electrocardiogram on admission. Results: At the end of this study, it was found that there was a significant increase in the sedation holiday group (Group II) over the no sedation group (Group I) regarding multiple organ dysfunction score, VAP, ventilator days, ICU stay, and hospital stay but there was no significant difference between both groups regarding mortality, spontaneous breathing trials, Glasgow Coma Scale, and complete blood count. Conclusions: Our results demonstrate that the use of sedatives can cause prolongation in the duration of mechanical ventilation, length of stay in the ICU, and total length of hospital stay. In addition, there is an increased risk of morbidity and mortality. It is possible to use a strategy of no sedation for critically ill patients undergoing mechanical ventilation without fears of failure.