6/28/23, 1:19 AM Daily ICU Sedation Holidays Pathway Feedback Search Clinical Topics Home Studies Daily ICU Sedation Holidays Daily ICU Sedation Holidays Disease Hypercapnic respiratory failure Trial question What is the effect of daily interruption of sedative infusions in patients undergoing mechanical ventilation? Study design Single center Open label RCT Population Characteristics of study participants 53.0% female N = 128 47.0% male 128 patients (68 female, 60 male) Inclusion criteria: adult patients receiving mechanical ventilation and continuous infusions of sedative drugs in medical ICU Key exclusion criteria: pregnancy, transfer from an outside institution where sedatives had already been administered, and admission after resuscitation from cardiac arrest Interventions N=68 intervention (interruptions of the sedative infusions until the patients were awake, on a daily basis) N=60 control (continuous infusions, interrupted only at the discretion of the clinicians in the ICU) https://web.pathway.md/studies/recnZEBGxcq7Iv2AI 1/2 6/28/23, 1:19 AM Daily ICU Sedation Holidays Pathway Primary outcome Percentage of days during which patients were awake while receiving a sedative infusion 85.5 % 85.5 64.1 % 42.8 % Significant increase 21.4 % NNH = 1 9 0.0 % Intervention Control Significant increase in the percentage of days during which patients were awake while receiving a sedative infusion (85.5% vs. 9%; AD 76.5%, 95% CI 31.11 to 121.89) Secondary outcomes No significant difference in death in the hospital (36% vs. 46.7%; RR 0.77, 95% CI -0.53 to 2.07) Safety outcomes No significant difference in adverse events including removal of endotracheal tube by the patient. Significant differences in diagnostic testing to assess changes in mental status (9% vs. 27%), non-awake during ICU stay (10.3% vs. 25%). Conclusion In adult patients receiving mechanical ventilation and continuous infusions of sedative drugs in medical ICU, intervention was superior to control with respect to the percentage of days during which patients were awake while receiving a sedative infusion. Reference Kress JP, Pohlman AS, O'Connor MF et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000 May 18;342(20):1471-7. Open reference URL https://web.pathway.md/studies/recnZEBGxcq7Iv2AI 2/2