Sedation in the ICU: Best Practices to Guide Care for the Mechanical Ventilated Patient

Page, Kimberly, and Joyce Conley

Mechanical ventilation is a medical treatment that provides an adjunct secure airway for providing supplemental oxygen for the intubated patient. While this therapy is necessary to sustain life, in some cases it is an uncomfortable situation that causes anxiety and fear in patients. The ability or inability to adequately sedate these patients could possible have a negative affect on length of ventilator days. The following question is posed, “In the mechanical ventilated patient, what effect does an anesthetic such as propofol have on length of ventilator days compared with benzodiazepines such as versed or ativan?”

The following PubMed literature research strategy was employed: (1) quantitative evidence composed of randomized studies of mechanical ventilated adult patients 18 years or older and (2) research articles consisting of mechanical ventilated adult patients and sedation protocols. Data was primarily collected from journal research articles. The articles consist of open label randomized trails of intensive care patients. The clients consist of medical and post-surgical patients that were on the mechanical ventilator for more than 24 hours. Various sedatives such as propofol, versed and ativan are compared as they relate to length of ventilator days while in the ICU. Propofol has resulted in shorter ventilator days when compared to other sedative medications.

A patient's ICU experience should not consist of fear, sleeplessness, or delirium related to the, lack of adequate sedation. For this can result in nurse harm or patient self harm leading to lengthier ventilator days. Hospitals are now implementing sedation protocols, screening tools, and other strategies to help ICUs utilize adequate and minimal sedatives as necessary for each patient to tolerate his ICU stay and have a speedy recovery.