The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

Tuberculosis and Respiratory Diseases

article

Yun Jung Jung¹  Wou Young Chung¹  Miyeon Lee¹  Keu Sung Lee¹  Joo Hun Park¹  Seung Soo Sheen¹  Sung Chul Hwang¹  Kwang Joo Park¹ 

[1] Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine

关键词: Conscious Sedation;    Ventilators;    Mechanical;    Hypnotics and Sedatives;    Consciousness Monitors;   

DOI  :  10.4046/trd.2012.73.3.151

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

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; r s =-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; r s =0.77), and RASS and BIS ( r s =-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.

【 授权许可】

CC BY-NC