Ting-Jhen Chen1, Yi-Wei Chung2, Pin-Yuan Chen3, Sophia H Hu4, Chuen-Chau Chang5, Shu-Hua Hsieh6, Bo-Cyuan Wang7, Hsiao-Yean Chiu1. 1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. 2. Department of Cardiology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan. 3. Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 4. Department of Nursing, School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan. 5. Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. 6. Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 7. Department of Nursing, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan.
Abstract
AIM: This study aimed to assess the effects of daily sedation interruption on the mechanical ventilation duration and relevant outcomes in mechanically ventilated patients in the intensive care unit (ICU). BACKGROUND: Previously, three meta-analyses on the association of daily sedation interruption with the mechanical ventilation duration have reported conflicting findings, and these did not support current guideline recommendations that daily sedation interruption can be routinely used in mechanically ventilated adult ICU patients. DESIGN: This was a systematic review and meta-analysis of randomized controlled studies. DATA SOURCES: Data were from PubMed, Embase, Cochrane Library, CINAHL, ProQuest dissertation and theses, Airiti Library, China National Knowledge Infrastructure, Wanfang Data Chinese, Science Direct and PsycINFO databases. REVIEW METHODS: Two reviewers independently assessed, extracted and appraised the included studies. Then, pooled estimates were calculated using a random-effects model. RESULTS: In total, 45 studies involving 5493 participants were included. Compared with controls, daily sedation interruption significantly reduced the mechanical ventilation duration, ICU stay length, sedation duration, and tracheostomy and ventilator-associated pneumonia risks (all p ≤ 0.001). Moreover, the Acute Physiology and Chronic Health Evaluation II score and study quality were significant moderators. CONCLUSION: Daily sedation interruption could substantially reduce the duration of mechanical ventilation, particularly when it was applied to patients with high disease severity.
AIM: This study aimed to assess the effects of daily sedation interruption on the mechanical ventilation duration and relevant outcomes in mechanically ventilated patients in the intensive care unit (ICU). BACKGROUND: Previously, three meta-analyses on the association of daily sedation interruption with the mechanical ventilation duration have reported conflicting findings, and these did not support current guideline recommendations that daily sedation interruption can be routinely used in mechanically ventilated adult ICU patients. DESIGN: This was a systematic review and meta-analysis of randomized controlled studies. DATA SOURCES: Data were from PubMed, Embase, Cochrane Library, CINAHL, ProQuest dissertation and theses, Airiti Library, China National Knowledge Infrastructure, Wanfang Data Chinese, Science Direct and PsycINFO databases. REVIEW METHODS: Two reviewers independently assessed, extracted and appraised the included studies. Then, pooled estimates were calculated using a random-effects model. RESULTS: In total, 45 studies involving 5493 participants were included. Compared with controls, daily sedation interruption significantly reduced the mechanical ventilation duration, ICU stay length, sedation duration, and tracheostomy and ventilator-associated pneumonia risks (all p ≤ 0.001). Moreover, the Acute Physiology and Chronic Health Evaluation II score and study quality were significant moderators. CONCLUSION: Daily sedation interruption could substantially reduce the duration of mechanical ventilation, particularly when it was applied to patients with high disease severity.
Authors: Nicola Gitti; Stefania Renzi; Mattia Marchesi; Michele Bertoni; Francisco A Lobo; Frank A Rasulo; Alberto Goffi; Matteo Pozzi; Simone Piva Journal: Front Med (Lausanne) Date: 2022-06-24