Daily Interruption of Sedation in Mechanically Ventilated Adults without Tracheostomy

Abstract

The use of sedative and analgesic dugs is essential in intensive care. The lowest effective doses should be used for the shortest period of time in order to limit the risk of serious complications. Daily interruption of sedation (DIS) is one strategy that has been shown to reduce overall sedative drug use and to promote earlier liberation from mechanical ventilation. However, uptake has been limited because of concerns over accidental removal of devices, the additional human resources required to accomplish the sedation break and the large numbers of patients who may be ineligible for the intervention. Some recent studies have challenged the usefulness of DIS and have promoted instead, nurse-controlled protocols and the use of sedation scoring tools. This review examines the evidence for and against DIS in the adult ICU setting.