Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients 英文参考文献.docVIP

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Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients 英文参考文献.doc

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Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients 英文参考文献

Available online /content/12/3/R70 Research Open Access Vol 12 No 3 Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients Marjolein de Wit1, Chris Gennings2, Wendy I Jenvey1 and Scott K Epstein3 1Pulmonary and Critical Care Division, Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, PO Box 980050, Richmond, VA 23298-0050, USA 2Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Box 980032, Richmond, VA, USA 3Tufts University School of Medicine, 145 Harrison Street, Boston, MA 02111, USA Corresponding author: Marjolein de Wit, mdewit@ Received: 1 May 2008 Revisions requested: 6 May 2008 Revisions received: 13 May 2008 Accepted: 20 May 2008 Published: 20 May 2008 Critical Care 2008, 12:R70 (doi:10.1186/cc6908) This article is online at: /content/12/3/R70 ? 2008 de Wit et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Daily interruption of sedation (DIS) and sedation algorithms (SAs) have been shown to decrease mechanical ventilation (MV) duration. We conducted a randomized study comparing these strategies. analysis demonstrated a significant difference in primary endpoint, and study termination was recommended. The DIS group had longer total duration of MV (median 6.7 versus 3.9 days; P = 0.0003), slower improvement of Sequential Organ Failure Assessment over time (0.70 versus 0.23 units per day; P = 0.025), longer ICU length of stay (15 versus 8 days; P 0.0001), and longer hospital length of stay (23 versus 12 days; P = 0.01). Methods Mechanically ventilated adults 18 years old or older in the medical intensiv