No-Sedation in Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients; A Randomized Controlled Trial.

Document Type : Original Article

Authors

1 Department of Chest, Faculty of Medicine, Assiut University, Egypt

2 Department of Anesthesia and Critical Care, Faculty of Medicine, Assiut University, Egypt

Abstract

Purpose: To compare no-sedation versus daily interruption of sedation (DIS) in COPD patients 
receiving mechanical ventilation upon the ventilator-free days. Martials and methods: Patients were 
randomly assigned to either DIS (n=50) or no-sedation (n=47) (intervention group). Patients failed to 
be managed by no-sedation strategy (n=9, 19.1%) were shifted to DIS, but analyzed in their parent 
group (intention to treat principle). Ventilator-free days was the primary outcome measure. Secondary 
outcome measures included: length of stay in the hospital and in intensive care unit (ICU), the 
incidence of ventilator-associated pneumonia (VAP), and weaning process (simple, difficult or 
prolonged). Nurse workload was assessed by the visual analogue scale (VAS). Results: no significant 
difference was found in ventilator-free days between DIS and no-sedation (mean 19.9 vs. 21.5 days, 
P=0.6). As well, we found no significant difference in length of ICU stay (P=0.7) and hospital stay 
(P=0.4). There was no significant difference in the incidence of VAP (P=1.0) nor in the weaning
process (simple, difficult or prolonged) (P=0.328) between the two groups. The no-sedation group 
showed a higher nurse workload in comparison to the DIS group. (4.38 vs. 5.69, P<0.001).
Conclusions: No-sedation protocol can be used safely in COPD patients with respiratory failure, but
with no influence upon the ventilator-free days. 

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Minia Journal of Medical Research
Volume 31, Issue 1
January 2020
Pages 12-21

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