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Open Access 01-08-2007 | Research

Mechanical ventilation with lower tidal volumes does not influence the prescription of opioids or sedatives

Authors: Esther K Wolthuis, Denise P Veelo, Goda Choi, Rogier M Determann, Johanna C Korevaar, Peter E Spronk, Michael A Kuiper, Marcus J Schultz

Published in: Critical Care | Issue 4/2007

Abstract

Introduction

We compared the effects of mechanical ventilation with a lower tidal volume (V_T) strategy versus those of greater V_T in patients with or without acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) on the use of opioids and sedatives.

Methods

This is a secondary analysis of a previously conducted before/after intervention study, which consisting of feedback and education on lung protective mechanical ventilation using lower V_T. We evaluated the effects of this intervention on medication prescriptions from days 0 to 28 after admission to our multidisciplinary intensive care unit.

Results

Medication prescriptions in 23 patients before and 38 patients after intervention were studied. Of these patients, 10 (44%) and 15 (40%) suffered from ALI/ARDS. The V_T of ALI/ARDS patients declined from 9.7 ml/kg predicted body weight (PBW) before to 7.8 ml/kg PBW after the intervention (P = 0.007). For patients who did not have ALI/ARDS there was a trend toward a decline from 10.2 ml/kg PBW to 8.6 ml/kg PBW (P = 0.073). Arterial carbon dioxide tension was significantly greater after the intervention in ALI/ARDS patients. Neither the proportion of patients receiving opioids or sedatives, or prescriptions at individual time points differed between pre-intervention and post-intervention. Also, there were no statistically significant differences in doses of sedatives and opioids. Findings were no different between non-ALI/ARDS patients and ALI/ARDS patients.

Conclusion

Concerns regarding sedation requirements with use of lower V_T are unfounded and should not preclude its use in patients with ALI/ARDS.

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Title: Mechanical ventilation with lower tidal volumes does not influence the prescription of opioids or sedatives
Authors: Esther K Wolthuis
Denise P Veelo
Goda Choi
Rogier M Determann
Johanna C Korevaar
Peter E Spronk
Michael A Kuiper
Marcus J Schultz
Publication date: 01-08-2007
Publisher: BioMed Central
Published in: Critical Care / Issue 4/2007
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc5969

At a glance: The STEP trials

Springer Medicine

Mechanical ventilation with lower tidal volumes does not influence the prescription of opioids or sedatives

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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