6/28/23, 11:53 PM Kress Pathway Feedback Search Clinical Topics Home Studies Kress Kress Trial question What is the role of daily interruption of sedative infusions in critically ill 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 who were receiving mechanical ventilation and continuous infusions of sedative drugs in a 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 (daily interruption of sedative infusions until the patients are awake) N=60 control (continuous infusion of sedatives with interruption only at the discretion of the clinicians in the ICU) Primary outcome Duration of mechanical ventilation 7.3 days 7.3 5.5 days 4.9 3.6 days 1.8 days Significant increase 0.0 days https://web.pathway.md/studies/rec1UWysXsTUlvK9W 1/2 6/28/23, 11:53 PM Kress Pathway y Intervention Control Significant increase in duration of mechanical ventilation (4.9 days vs. 7.3 days; RR 1.9, 95% CI 1.3 to 2.7) Secondary outcomes Significant increase in length of stay in the ICU (6.4 days vs. 9.9 days; RR 1.6, 95% CI 1.1 to 2.3) No significant difference in in-hospital death (36% vs. 46.7%; RR 0.77, 95% CI -0.53 to 2.07) Safety outcomes No significant differences in removal of the endotracheal tube by the patient, noninvasive ventilation after extubation, reintubation, tracheostomy, long-term ventilation, withdrawal of care. Significant differences in home discharge (59% vs. 40%), unawakened during the stay (0.10% vs. 0.25%), death in a coma (0.09% vs. 0.22%). Conclusion In adult patients who were receiving mechanical ventilation and continuous infusions of sedative drugs in a medical ICU, intervention was superior to control with respect to duration of mechanical ventilation. 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/rec1UWysXsTUlvK9W 2/2