Change in hypnotic sedative choice over time as a surrogate marker of improved performance

Excerpt

Daily sedation holds, particularly when combined with protocolised spontaneous breathing trials, are one of the only strategies available to intensivists that produce an outcome benefit [1]. This evidence has also provoked a renewed interest in the choice of both hypnotic and analgesic agents. Midazolam is known to produce unpredictable awakening and may prolong time to extubation when infusions continue longer than 48 to 72 hours. In contrast, propofol may enhance the benefit to critically ill patients of the daily sedation hold due to its pharmacokinetic properties [2]. This study examines the hypothesis that the ratio of propofol/midazolam use can be used as a surrogate marker of good practice and utilises the potential of the pharmacy procurement database. …