title: Toward less sedation in the intensive care unit: a prospective observational study.
abstract: OBJECTIVE
  Excessive sedation is associated with prolonged mechanical ventilation and longer intensive care unit (ICU) and hospital stays. We evaluated the feasibility of using minimal sedation in the ICU.
  
  
  METHODS
  Prospective observational study in a university hospital 34-bed medico-surgical department of intensive care. All adult patients who stayed in the ICU for more than 12 hours over a 2-month period were included. Intensive care unit admission diagnoses, severity scores, use of sedatives and/or opiates, duration of mechanical ventilation, length of ICU stay, and 28-day mortality were recorded for each patient.
  
  
  RESULTS
  Of the 335 patients (median age, 61 years) admitted during the study period, 142 (42%) received some sedation, most commonly with midazolam and propofol. Sedative agents were administered predominantly for short periods of time (only 10% of patients received sedation for >24 hours). One hundred fifty-five patients (46%) received mechanical ventilation, generating 15,240 hours of mechanical ventilation, of these, only 2993 (20%) hours were accompanied by a continuous sedative infusion. Self-extubation occurred in 6 patients, but only 1 needed reintubation.
  
  
  CONCLUSIONS
  In a mixed medical-surgical ICU, minimal use of continuous sedation seems feasible without apparent adverse effects.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
authors.forename: Diamantino R
authors.initials: DR
authors.lastname: Salgado
authors.forename: Raphaël
authors.initials: R
authors.lastname: Favory
authors.forename: Mateus
authors.initials: M
authors.lastname: Goulart
authors.forename: Serge
authors.initials: S
authors.lastname: Brimioulle
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D018806:APACHE; D000368:Aged; D016292:Procedural Sedation / Q000379:methods; D054810:Deep Sedation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007362:Intensive Care Units / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial
chemical_list: D006993:Hypnotics and Sedatives