Daily Sedation Interruption Versus Targeted Light Sedation Strategies in ICU Patients

摘要

Objective: The updated clinical practice guidelines for the management of pain, agitation, and delirium recommend either daily sedation interruption or maintaining light levels of sedation as methods to improve outcomes for patients who are sedated in the ICU. We review the evidence supporting both methods and discuss whether one method is preferable or if they should be used concurrently.Data Source: Original research articles identified using the electronic PubMed database.Study Selection and Data Extraction: Randomized controlled trials and large prospective cohort studies of mechanically ventilated ICU patients requiring sedation were selected. Data Synthesis: The methods of daily sedation interruption and targeting light sedation levels (including avoidance of deep sedation) are safe in critically ill patients with no increase, and a potential decrease, in long-term psychiatric disturbances. Randomized trials comparing these methods with standard care, which has traditionally involved moderate to heavy sedation, found that both methods reduced duration of mechanical ventilation and ICU length of stay.