Universität zu Köln

Schneider, Ralph ORCID: 0000-0003-0012-4962, Puetz, Andreas, Vassiliou, Timon, Wiesmann, Thomas, Lewan, Ulrike, Wulf, Hinnerk, Bartsch, Detlef K. and Rolfes, Caroline (2017). The Benefit of Benzodiazepine Reduction: Improving Sedation in Surgical Intensive Care. Indian J. Crit. Care Med., 21 (5). S. 274 - 281. MUMBAI: WOLTERS KLUWER MEDKNOW PUBLICATIONS. ISSN 1998-359X

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Abstract

Aims: Sedation, as it is often required in critical care, is associated with immobilization, prolonged ventilation, and increased morbidity. Most sedation protocols are based on benzodiazepines. The presented study analyzes the benefit of benzodiazepine-free sedation. Methods: In 2008, 134 patients were treated according to a protocol using benzodiazepine and propofol (Group 1). In 2009, we introduced a new sedation strategy based on sufentanil, nonsteroidal anti-inflammatory drugs, neuroleptics, and antidepressants, which was applied in 140 consecutive patients (Group 2). Depth of sedation, duration of mechanical ventilation, duration of Intensive Care Unit, and hospital stay were analyzed. Results: Group 1 had both a longer duration of deep sedation (18.7 +/- 2.5 days vs. 12.6 +/- 1.85 days, P = 0.031) and a longer duration of controlled ventilation (311, 35 +/- 32.69 vs. 143, 96 +/- 20.76 h, P < 0.0001) than Group 2. Ventilator days were more frequent in Group 1 (653, 66 +/- 98.37 h vs. 478, 89 +/- 68.92 h, P = 0.128). Conclusions: The benzodiazepine-free sedation protocol has been shown to significantly reduce depth of sedation and controlled ventilation. Additional evidence is needed to ascertain reduction of ventilator days which would not only be of benefit for the patient but also for the hospital Management.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schneider, Ralph UNSPECIFIED orcid.org/0000-0003-0012-4962 UNSPECIFIED Puetz, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Vassiliou, Timon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesmann, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewan, Ulrike UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulf, Hinnerk UNSPECIFIED UNSPECIFIED UNSPECIFIED Bartsch, Detlef K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rolfes, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-231803
DOI:	10.4103/ijccm.IJCCM_67_17
Journal or Publication Title:	Indian J. Crit. Care Med.
Volume:	21
Number:	5
Page Range:	S. 274 - 281
Date:	2017
Publisher:	WOLTERS KLUWER MEDKNOW PUBLICATIONS
Place of Publication:	MUMBAI
ISSN:	1998-359X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CRITICALLY-ILL PATIENTS; MECHANICALLY VENTILATED PATIENTS; NEUROMUSCULAR BLOCKING-AGENTS; NATIONAL-SURVEY; RANDOMIZED-TRIAL; DAILY INTERRUPTION; CLINICAL-PRACTICE; UNIT PATIENTS; NO-SEDATION; ANALGESIA Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23180