Daily sedation interruption and mechanical ventilation weaning: a literature review

Anaesthesiol Intensive Ther. 2019;51(5):380-389. doi: 10.5114/ait.2019.90921.

Abstract

Daily sedation interruption (DSI) is a method used since the beginning of the millennium to streamline sedation in critically ill patients under mechanical ventilation and improve clinical outcomes. The purpose was to assess whether there is a correlation between DSI and weaning from mechanical ventilation. We designed a literature review via searching PubMed, UpToDate and Google Scholar for relevant key terms from inception until March 2019. Literature retrieved included nine randomized controlled trials. When compared to usual practice, it is superior in terms of duration of mechanical ventilation, stay in the intensive care unit, hospitalization, adverse effect occurrence and total cost of therapy. Comparison with other sedation protocols produces conflicting results. DSI, and protocolized sedation in general, are safe methods to perform to facilitate earlier weaning and improved clinical outcomes. Future research should focus on minimizing bias by conducting double-blinded studies and studying different patient subgroups.

Keywords: daily interruption; intensive care unit; mechanical ventilation; protocolized sedation; weaning; sedation.

Publication types

  • Review

MeSH terms

  • Critical Illness
  • Drug Administration Schedule
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Intensive Care Units
  • Randomized Controlled Trials as Topic
  • Respiration, Artificial / methods*
  • Time Factors
  • Ventilator Weaning / methods*

Substances

  • Hypnotics and Sedatives