Κατεύθυνση Καρδιοπνευμονική Αποκατάσταση και Αποκατάσταση Πασχόντων ΜΕΘLibrary of the School of Health Sciences
Ιωάννης Βασιλειάδης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικολέτα Ροβίνα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Διακοπή ηρεμιστικών κατά τη διάρκεια αποδέσμευσης από μηχανική αναπνοή
Interruption of sedatives during weaning from mechanical ventilation
Background: Daily Sedation Interruption (DSI) is a method used since the beginning of the millennium to streamline sedation in critically ill patients under mechanical ventilation and improve clinical outcomes.
Aim: To assess whether there is a correlation between DSI and weaning from mechanical ventilation.
Design: Systematic review.
Methods: PubMed, UpToDate and Google Scholar were searched for relevant key terms. Literature retrieved included eleven randomized controlled trials, three blinded studies and two surveys in the English language from May 2000 to January 2018.
Results: The research indicates that DSI has a reported compliance rate of up to 62% by intensive care physicians. When compared to usual practice, it is superior in terms of duration of mechanical ventilation, stay in the Intensive Care Unit, hospitalization, occurrence of adverse effects and total cost of therapy. Comparison with other sedation protocols produces conflicting results.
Conclusions: DSI, as well as protocolized sedation in general, is a safe method to perform and seems to facilitate earlier weaning process and improve clinical outcomes. Meticulous future research, however, should follow to minimize bias, to study different patient subgroups and investigate how the weaning process is affected.
Main subject category:
Daily sedation interruption, Weaning, Mechanical ventilation, Intensive Care Unit