Intubated ICU Patients Need Fewer Days of Ventilation When Not Continuously Sedated

Critically ill patients who require mechanical ventilation in the emergency department usually receive postintubation sedation, but how long should sedation be continued? In a prospective study from Denmark, 140 critically ill adult patients who were expected to require mechanical ventilation for at least 24 hours were randomized within 24 hours after intubation to no ongoing sedation or sedation with daily interruption to wake the patient. Sedation was provided with propofol infusion (20 mg/mL titrated to a Ramsay score of 3–4) for 48 hours followed by midazolam infusion (1 mg/mL titrated to a Ramsay score of 3–4). Morphine (2.5 or 5 mg) was administered to both groups as needed to relieve patient discomfort.

Twenty-seven patients who died …