Sedating Mechanically Ventilated Patients

• Providing appropriate analgesia and sedation to mechanically ventilated patients is of paramount importance.
• In a recent systematic review and meta-analysis, Stephens et al. assessed the impact of deep sedation within the first 48 hours of initiation of mechanical ventilation.
• In 9 studies that included over 4,500 patients, deep sedation within the first 48 hours of initiation of mechanical ventilation was associated with increased mortality, increased ICU LOS, and increased frequency of delirium.
• Take Home Points
  • When possible, target lighter levels of sedation in mechanically ventiilated patients.
  • Though no universally accepted definition of light sedation exists, most studies use a RASS of -2 to +1

References

1. Stephens RJ, et al. Practice patterns and outcomes associated with early sedation depth in mechanically ventilated patients: A systematic review and meta-analysis. Crit Care Med. 2018; 46:471-9.
2. Devlin JW, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018; 46:e825-e873.