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Settings: Multicenter randomized controlled trial
Patients: 710 patients
Intervention: 345 patients. no sedative but only boluses of morphine as clinically indicated (Sedation group)
Comparison: 356 patients. light sedation with daily interruption (Nonsedation group)
Outcome: all-cause mortality at 90 days after randomization
Study Results:
42.4% of nonsedation group died vs 37% of sedation group (95% confidence interval [CI], −2.2 to 12.2; P = 0.65).
Number of ventilator-free days for nonsedation group was 27 days vs. 26 for sedation group.
Discussion:
This study did not agree with previous studies that lighter sedation was associated with shorter length of stay on mechanical ventilation , ICU or hospital. The authors attributed to the findings that RASS score was not significantly different between the 2 groups.
Conclusion:
Critically ill adult patients receiving mechanical ventilation, there was no difference in 90-day mortality between patients receiving light sedation or no sedation.
References
Olsen HT, Nedergaard HK, Strøm T1, Oxlund J, Wian KA, Ytrebø LM1, Kroken BA, Chew M, Korkmaz S, Lauridsen JT, Toft P.
Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients.
N Engl J Med. 2020 Feb 16. doi: 10.1056/NEJMoa1906759. [Epub ahead of print]