Thursday January 25, 2007
Daily sedative interruption in mechanically ventilated patients and risk for coronary artery disease

It has now been established and pretty much a standard of practice to have every morning sedative interruption in mechanically ventilated patients to decrease ventilator days, ventilator associated pneumonia and overall outcome. But there is always a criticism and concern that daily sedative interruption in mechanically ventilated patients may increase the risk for coronary artery disease.

Dr kress (leading author of original daily sedation break study 2) looked into this issue. His study to be published in feb. 2007 of Critical Care medicine 1 looked into ST-segment analysis of 74 patients.

18 of 74 patients (24%) demonstrated ischemic changes. Despite changes in vital signs and catecholamine levels during sedative interruption, fraction of ischemic time did not differ between the time awake vs. time sedated. Study found that daily sedative interruption is not associated with an increased occurrence of myocardial ischemia in mechanically ventilated patients.



Reference: click to get abstract

1. Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease. Critical Care Medicine. 35(2):365-371, February 2007.

2. Daily Interruption of Sedative Infusions in Critically Ill Patients Undergoing Mechanical Ventilation - N Engl J Med 2000; 342:1471-1477, May 18, 2000.