Daily sedation interruption; a glass half empty?

• Published in: Anaesthesia and intensive care Vol. 39; no. 3; pp. 339 - 341
• Main Authors: Shehabi, Y, Weisbrodt, L
• Format: Journal Article
• Language: English
• Published: United States Sage Publications Ltd. (UK) 01.05.2011; Sage Publications Ltd
• Subjects: Complications and side effects; Conscious Sedation - methods; Critical care medicine; Critical Illness; Dosage and administration; Humans; Hypnotics; Hypnotics and Sedatives - administration & dosage; Sedatives; Australia
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x1103900302

The last decade witnessed an exponential rise in the number of publications addressing management of sedation during critical illness. In 1998 Kollef and colleagues 1 suggested that the use of continuous infusions of sedatives may be associated with prolonged duration of mechanical ventilation and intensive care unit (ICU) stay. This was followed by a landmark study by Kress and colleagues 2 who demonstrated significant reduction in ventilation time and ICU stay with daily interruption of sedative infusions (DSI). Subsequent investigations have been consistent with the notion that strategies that reduce sedation depth such as algorithms and protocols for sedation management 3-5 and the use of validated sedation scales 6 can improve patient outcomes. This academic exuberance led to an endorsement of these strategies, and in particular DSI, by the UK Department of Health ( www.clean-safe-care.nhs.uk ), the Institute for Healthcare Improvement ( www.IHI.org ) and Safer Health Care Now! ( www.saferhealthcarenow.ca ).