The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit

Elliott, R; McKinley, S; Aitken, LM; Hendrikz, J

The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit

Elliott, R

McKinley, S Aitken, LM Hendrikz, J

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Publication Type:: Journal Article
Citation:: Intensive Care Medicine, 2006, 32 (10), pp. 1506 - 1514
Issue Date:: 2006-10-01

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Field	Value	Language
dc.contributor.author	Elliott, R https://orcid.org/0000-0002-9239-7126	en_US
dc.contributor.author	McKinley, S	en_US
dc.contributor.author	Aitken, LM	en_US
dc.contributor.author	Hendrikz, J	en_US
dc.date.available	2006-06-30	en_US
dc.date.issued	2006-10-01	en_US
dc.identifier.citation	Intensive Care Medicine, 2006, 32 (10), pp. 1506 - 1514	en_US
dc.identifier.issn	0342-4642	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4594
dc.description.abstract	Objective: To examine the effect of an algorithm-based sedation guideline developed in a North American intensive care unit (ICU) on the duration of mechanical ventilation of patients in an Australian ICU. Design and setting: The intervention was tested in a pre-intervention, post-intervention comparative investigation in a 14-bed adult intensive care unit. Patients: Adult mechanically ventilated patients were selected consecutively (n = 322). The pre-intervention and post-intervention groups were similar except for a higher number of patients with a neurological diagnosis in the pre-intervention group. Intervention: An algorithm-based sedation guideline including a sedation scale was introduced using a multifaceted implementation strategy. Measurements and results: The median duration of ventilation was 5.6 days in the post-intervention group, compared with 4.8 days for the pre-intervention group (P = 0.99). The length of stay was 8.2 days in the post-intervention group versus 7.1 days in the pre-intervention group (P = 0.04). There were no statistically significant differences for the other secondary outcomes, including the score on the Experience of Treatment in ICU 7 item questionnaire, number of tracheostomies and number of self-extubations. Records of compliance to recording the sedation score during both phases revealed that patients were slightly more deeply sedated when the guideline was used. Conclusions: The use of the algorithm-based sedation guideline did not reduce duration of mechanical ventilation in the setting of this study. © 2006 Springer-Verlag.	en_US
dc.relation.ispartof	Intensive Care Medicine	en_US
dc.relation.isbasedon	10.1007/s00134-006-0309-0	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hypnotics and Sedatives	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Respiration, Artificial	en_US
dc.subject.mesh	Length of Stay	en_US
dc.subject.mesh	Monte Carlo Method	en_US
dc.subject.mesh	Statistics, Nonparametric	en_US
dc.subject.mesh	Algorithms	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Intensive Care Units	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	32	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	110310 Intensive Care	en_US
utslib.for	1103 Clinical Sciences	en_US
dc.location.activity	Wellington, New Zealand
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	32	en_US

Abstract:

Objective: To examine the effect of an algorithm-based sedation guideline developed in a North American intensive care unit (ICU) on the duration of mechanical ventilation of patients in an Australian ICU. Design and setting: The intervention was tested in a pre-intervention, post-intervention comparative investigation in a 14-bed adult intensive care unit. Patients: Adult mechanically ventilated patients were selected consecutively (n = 322). The pre-intervention and post-intervention groups were similar except for a higher number of patients with a neurological diagnosis in the pre-intervention group. Intervention: An algorithm-based sedation guideline including a sedation scale was introduced using a multifaceted implementation strategy. Measurements and results: The median duration of ventilation was 5.6 days in the post-intervention group, compared with 4.8 days for the pre-intervention group (P = 0.99). The length of stay was 8.2 days in the post-intervention group versus 7.1 days in the pre-intervention group (P = 0.04). There were no statistically significant differences for the other secondary outcomes, including the score on the Experience of Treatment in ICU 7 item questionnaire, number of tracheostomies and number of self-extubations. Records of compliance to recording the sedation score during both phases revealed that patients were slightly more deeply sedated when the guideline was used. Conclusions: The use of the algorithm-based sedation guideline did not reduce duration of mechanical ventilation in the setting of this study. © 2006 Springer-Verlag.

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http://hdl.handle.net/10453/4594