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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2006

01-10-2006 | Original

The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit

Authors: Rosalind Elliott, Sharon McKinley, Leanne M. Aitken, Joan Hendrikz

Published in: Intensive Care Medicine | Issue 10/2006

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Abstract

Objective

To examine the effect of an algorithm-based sedation guideline developed in a North American intensive care unit (ICU) on the duration of mechanical ventilation of patients in an Australian ICU.

Design and setting

The intervention was tested in a pre-intervention, post-intervention comparative investigation in a 14-bed adult intensive care unit.

Patients

Adult mechanically ventilated patients were selected consecutively (n = 322). The pre-intervention and post-intervention groups were similar except for a higher number of patients with a neurological diagnosis in the pre-intervention group.

Intervention

An algorithm-based sedation guideline including a sedation scale was introduced using a multifaceted implementation strategy.

Measurements and results

The median duration of ventilation was 5.6 days in the post-intervention group, compared with 4.8 days for the pre-intervention group (P = 0.99). The length of stay was 8.2 days in the post-intervention group versus 7.1 days in the pre-intervention group (P = 0.04). There were no statistically significant differences for the other secondary outcomes, including the score on the Experience of Treatment in ICU 7 item questionnaire, number of tracheostomies and number of self-extubations. Records of compliance to recording the sedation score during both phases revealed that patients were slightly more deeply sedated when the guideline was used.

Conclusions

The use of the algorithm-based sedation guideline did not reduce duration of mechanical ventilation in the setting of this study.
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Metadata
Title
The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit
Authors
Rosalind Elliott
Sharon McKinley
Leanne M. Aitken
Joan Hendrikz
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 10/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0309-0

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