ABSTRACT
Objective is to determine whether daily interruption of sedative infusions would decrease the duration of mechanical ventilation and the length of stay in the intensive care. A prospective, randomized, controlled trial. Setting: Intensive care unit in El-Minia University Hospital. Forty-five adult patients presenting with respiratory failure [acute exacerbation of chronic obstructive pulmonary disease] who were receiving mechanical ventilation and continuous infusion of sedative drugs. In the intervention group, the sedative infusions were interrupted until the patients were awake, on a daily basis; in the control group, the infusions were interrupted only at the discretion of the clinicians in the intensive care unit according to the condition of the patient The mean duration of mechanical ventilation was 4.6 +/- 1.2 days in the intervention group, as compared with 7.3 +/- 1.5 days in the control group, and the length of study in the intensive care unit was 5.8 +/- 2.2 days as compared with 9.4 +/- 2.6 days respectively. The wake up time was significantly shorter in patients who received propofol infusion [of both groups] as compared with patients who received midazolam. The triglycerides level were significantly higher in patients who received propofol sedation [of both group] with insignificant changes in patients who received midazolam Adverse events [e.g. removal of the endotracheal tube by the patient] occurred in two patients of the intervention group and three patients in the control group. The daily interruption of sedative drug infusions decreases the duration of mechanical ventilation and the length of stay in the intensive care unit