Sedation protocols to reduce duration of mechanical ventilation in the ICU: a Cochrane Systematic Review

Aitken, Leanne M., Bucknall, Tracey, Kent, Bridie, Mitchell, Marion, Burmeister, Elizabeth and Keogh, Samantha 2016, Sedation protocols to reduce duration of mechanical ventilation in the ICU: a Cochrane Systematic Review, Journal of advanced nursing, vol. 72, no. 2, pp. 261-272, doi: 10.1111/jan.12843.

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Title Sedation protocols to reduce duration of mechanical ventilation in the ICU: a Cochrane Systematic Review
Author(s) Aitken, Leanne M.
Bucknall, TraceyORCID iD for Bucknall, Tracey
Kent, Bridie
Mitchell, Marion
Burmeister, Elizabeth
Keogh, Samantha
Journal name Journal of advanced nursing
Volume number 72
Issue number 2
Start page 261
End page 272
Total pages 12
Publisher Wiley
Place of publication London, Eng.
Publication date 2016-02
ISSN 1365-2648
Keyword(s) critical care
evidence-based practice
systematic reviews and meta-analyses
Summary AIMS: Assess the effects of protocol-directed sedation management on the duration of mechanical ventilation and other relevant patient outcomes in mechanically ventilated intensive care unit patients. BACKGROUND: Sedation is a core component of critical care. Sub-optimal sedation management incorporates both under- and over-sedation and has been linked to poorer patient outcomes. DESIGN: Cochrane systematic review of randomized controlled trials. DATA SOURCES: Cochrane Central Register of Controlled trials, MEDLINE, EMBASE, CINAHL, Database of Abstracts of Reviews of Effects, LILACS, Current Controlled Trials and US National Institutes of Health Clinical Research Studies (1990-November 2013) and reference lists of articles were used. REVIEW METHODS: Randomized controlled trials conducted in intensive care units comparing management with and without protocol-directed sedation were included. Two authors screened titles, abstracts and full-text reports. Potential risk of bias was assessed. Clinical, methodological and statistical heterogeneity were examined and the random-effects model used for meta-analysis where appropriate. Mean difference for duration of mechanical ventilation and risk ratio for mortality, with 95% confidence intervals, were calculated. RESULTS: Two eligible studies with 633 participants comparing protocol-directed sedation delivered by nurses vs. usual care were identified. There was no evidence of differences in duration of mechanical ventilation or hospital mortality. There was statistically significant heterogeneity between studies for duration of mechanical ventilation. CONCLUSIONS: There is insufficient evidence to evaluate the effectiveness of protocol-directed sedation as results from the two randomized controlled trials were conflicting.
Language eng
DOI 10.1111/jan.12843
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley
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