ArticleEClinicalMedicine2020
The effects of sedation cessation within the first four hours of intensive care unit admission in mechanically ventilated critically ill patients - a quality improvement study.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- What are the perceptions of intensive care staff about their sedation practices when caring for a mechanically ventilated patient?: A systematic mixed-methods review.International journal of nursing studies advances · 2022Review
- Intensive Care Unit-Acquired Weakness: Not just Another Muscle Atrophying Condition.International journal of molecular sciences · 2020Review
- The Effect of Sedation Protocol on Sedation Level and Pharmacological and Non-Pharmacological Interventions on Mechanically Ventilated Patients.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly deep sedation in mechanically ventilated patients during the first 48 h of intensive care unit (ICU) admission can be associated with adverse outcomes. We hypothesised that moving the 'daily sedation break' process forwards, might allow earlier titration of sedation to target levels - an 'early sedation cessation' (ESC).
methodsWe commenced a quality improvement project with the primary outcome being to stop sedation completely, within 4 h of ICU admission, in 95% of eligible patients. This was done by small, step-wise tests of change. No ethical approval was required.
findingsBetween 1 February 2014 and 31 January 2018, 1787 intubated patients were included. 1052 received an 'ESC' within 4 h ('Yes'), 545 were excluded ('Excluded'), and 190 were inadvertently omitted from 'ESC' ('No'). The primary aim was achieved for the first time after 12 months. Compared to the 'Yes' group, the 'Excluded' group received 38% more propofol in the first 48 h of admission (IRR 1.38 (1.31-1.47),
interpretationCeasing sedative infusions as soon as possible, is safe and feasible, in both medical and surgical patients, and can be implemented into 'real life' with no additional staffing.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.