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The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

Authors
Jung, YJ; Chung, WY; Lee, M; Lee, KS; Park, JH; Sheen, SS; Hwang, SC; Park, KJ
Citation
Tuberculosis and respiratory diseases, 73(3):151-161, 2012
Journal Title
Tuberculosis and respiratory diseases
ISSN
1738-35362005-6184
Abstract
Background: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation.



Methods: A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG.



Results: In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, 1.3±0.5 µg/kg/min; day 2, 0.9±0.4 µg/kg/min; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; rs=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; rs=0.77), and RASS and BIS (rs=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS.



Conclusion: Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.
Keywords
Conscious SedationVentilatorsMechanicalHypnotics and SedativesConsciousness Monitors
DOI
10.4046/trd.2012.73.3.151
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Science
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
AJOU Authors
정, 윤정정, 우영이, 규성박, 주헌신, 승수황, 성철박, 광주
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