A critical review of daily sedation interruption in the intensive care unit

O'Connor, Mark., Bucknall, Tracey. and Manias, Elizabeth. 2009, A critical review of daily sedation interruption in the intensive care unit, Journal of clinical nursing, vol. 18, no. 9, pp. 1239-1249, doi: 10.1111/j.1365-2702.2008.02513.x.

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Title A critical review of daily sedation interruption in the intensive care unit
Author(s) O'Connor, Mark.
Bucknall, Tracey.ORCID iD for Bucknall, Tracey. orcid.org/0000-0001-9089-3583
Manias, Elizabeth.ORCID iD for Manias, Elizabeth. orcid.org/0000-0002-3747-0087
Journal name Journal of clinical nursing
Volume number 18
Issue number 9
Start page 1239
End page 1249
Total pages 11
Publisher Blackwell Scientific
Place of publication Oxford, England
Publication date 2009-05
ISSN 0962-1067
Keyword(s) adverse outcomes
critically ill patients
daily sedation interruption
intensive care unit
sedation protocol
Summary Background. Daily sedation interruption (DSI) has been proposed as a method of improving sedation management of critically ill patients by reducing the adverse effects of continuous sedation infusions.

Aim. To critique the research regarding daily sedation interruption, to inform education, research and practice in this area of intensive care practice.

Design. Literature review.

Method. Medline, CINAHL and Web of Science were searched for relevant key terms. Eight research-based studies, published in the English language between 1995–December 2006 and three conference abstracts were retrieved.

Results. Of the eight articles and three conference abstracts reviewed, five originated from one intensive care unit (ICU) in the USA. The research indicates that DSI reduces ventilation time, length of stay in ICU, complications of critical illness, incidence of post-traumatic stress disorder and is reportedly used by 15–62% of ICU clinicians in Australia, Europe, USA and Canada.

Conclusions. DSI improves patients' physiological and psychological outcomes when compared with routine sedation management. However, research relating to these findings has methodological limitations, such as the use of homogenous samples, single-centre trials and retrospective design, thus limiting their generalisability.

Relevance to clinical practice. DSI may provide clinicians with a simple, cost-effective method of reducing some adverse effects of sedation on ICU patients. However, the evidence supporting DSI is limited and cannot be generalised to heterogeneous ICU populations internationally. More robust research is required to assess the potential impact of DSI on the physical and mental health of ICU survivors.
Language eng
DOI 10.1111/j.1365-2702.2008.02513.x
Field of Research 110310 Intensive Care
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2009, Blackwell Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30017897

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