Feasibility of a sedation wake-up trial and spontaneous breathing trial in critically ill trauma patients: a secondary analysis.
OBJECTIVE
To determine the feasibility of conducting a sedation wake-up trial (SWT) plus a spontaneous breathing trial (SBT) in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients' physiological responses; and to maintain patient safety.


METHODS
A secondary analysis of the intervention group from a trial of 20 mechanically ventilated patients receiving SWT plus SBT in a trauma-intensive care unit.


RESULTS
Patients passed 67% of the 39 SWTs performed; those who failed presented RASS scores of +1 and +2 (70%), tachycardia (15%) or ventilator asynchrony (15%). Eighteen patients tolerated their first SBT, and after the second SBT, more than half of the patients were discontinued from the mechanical ventilator. A significant increase from the beginning to the end of the SWT was found in heart rate (p=.021), respiratory rate (p=.043) and systolic blood pressure (p=.04). Although these measures increased significantly, their overall mean did not increase by 20%.


CONCLUSIONS
SWT plus SBT was well tolerated and successfully implemented. Our data showed that it is not necessary to withhold continuous-infusion analgesia during the SWT.
University of Puerto Rico, Medical Sciences Campus, School of Nursing, Puerto Rico. milagros.figueroa@upr.edu
Milagros I
MI
Figueroa-Ramos
Carmen Mabel
CM
Arroyo-Novoa
Geraldine
G
Padilla
Pablo
P
Rodríguez-Ortiz
Bruce A
BA
Cooper
Kathleen A
KA
Puntillo
D001794:Blood Pressure; D003422:Critical Care / Q000379:methods*; D064648:Critical Care Nursing; D003693:Delirium / Q000517:prevention & control; D005240:Feasibility Studies; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007362:Intensive Care Units; D007902:Length of Stay; D056152:Respiratory Rate; D015300:Ventilator Weaning / Q000379:methods*; D014947:Wounds and Injuries / Q000451:nursing / Q000628:therapy*
D006993:Hypnotics and Sedatives