Effect of a sedation guideline on the duration of mechanical ventilation and length of stay in intensive care unit

Abstract

Introduction: Achieving an adequate level of sedation for patients who receive mechanical ventilation is a big critical care challenge. This study aimed to determine the effect of sedation guideline on the duration of mechanical ventilation and length of stay inintensive care unit (ICU) patients. Materials and Methods: This clinical trial study was conducted in an ICU located in Isfahan, Iran, from September 2012 to February 2103. A sedation guideline was developed based on the recent 10 years existing literatures as well as the recommendations of the practicing anesthesiologists and nurses. Coresspondingly, fifty patients who had undergone abdominal surgery with vertical incision and were receiving mechanical ventilation were recruited by convenience sampling method and divided to treatment (guideline) and control (routine) groups. At first, twenty five patients (need to sedation based on Richmond scale) were sedated by using the routine sedation method. The remaining 25 patients were treated by sedation guideline. The two groups were compared in terms of duration of mechanical ventilation and length of stay in ICU. Data collection tools were include patients’ demographic characteristics questionnaire, APACHE II, Richmond scale, the dose of administered sedatives, the duration of mechanical ventilation and length of ICU stay. Results: About 76 of the participants were male. The mean of the participants’ age was 53.3. The mean of mechanical ventilation duration in the control group was significantly different from the treatment group (220.80±91.4 vs. 116.4±96.4 hours; P value <0.001). Moreover, the implementation of the developed sedation guideline decreased the length of staying in ICU by 8.6 days. Conclusion: In patients receiving mechanical ventilation and requiring sedative, the use of sedation guideline decreases the duration of mechanical ventilation and the length of ICU stay. Hence, it is recommended using this guideline by nurses in patient sedation. © 2017, Semnan University of Medical Sciences. All rights reserved.