I came across this study promoting no sedation for mechanically ventilated patients.
The study, originally published in 2010, demonstrated that patients who were not sedated during mechanical ventilation had a reduced length of mechanical ventilation as well as a reduction in both the ICU and hospital length of stay. Critics of the study stated that morphine, which was used for pain relief in the un-sedated control group, was used as a pseudo-sedation, suggesting that there was no real difference in patients’ consciousness between the two groups. In addition, critics pointed out that un-sedated patients would increase workload of nurses significantly adding cost to the hospital. This criticism prompted the authors of the study to present new data collected during the original trial.
The new data presented the results from the tool (Richmond Agitation and Sedation Scale [RASS]) used to assess the patients’ level of consciousness in both the sedated and un-sedated group. The results showed that the un-sedated group had significantly lower RASS scores than the sedated group demonstrating that there was a big difference in LOC between the groups. In addition, the authors presented the results from the tool used to measure the workload of the nurses (Nursing Care Recording System) which demonstrated that the work load of the nurses did not significantly increase when caring for un-sedated patients.
This study demonstrated that less sedation for a mechanically ventilated patient can mean better outcomes for the patient, cost efficiency for the hospital, and no perceived increase of workload to the nurse. I am curious to ask the nurses and MDs at VCMC about this topic. Check it out!
Laerkner, E., Stroem, T., & Toft, P. (2016). No-sedation during mechanical ventilation: impact
on patient’s consciousness, nursing workload and costs. Nursing In Critical Care, 21(1), 28-