Enhancing Sedation Management in Mechanically Ventilated Patients in the Critical Care Unit

Abdul Samad; Summiya Rahman; Syed Ali Kazmi; Muhammad Yasir; Haider Ali Shah; Zubair Sharif

doi:10.70749/ijbr.v3i2.697

Authors

Abdul Samad Faculty of Allied Health Sciences, Superior University, Lahore, Punjab, Pakistan.
Summiya Rahman Khyber Medical University, Peshawar, KP, Pakistan.
Syed Ali Kazmi National Hospital, Lahore, Punjab, Pakistan.
Muhammad Yasir University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Haider Ali Shah University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Zubair Sharif Faculty of Allied Health Sciences, Superior University, Lahore, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.697

Keywords:

Sedation Management, Mechanically Ventilated Patients, Left Ventricular Function, Sedation Protocol, Propofol, Midazolam, Dexmedetomidine, Mechanical Ventilation

Abstract

Background: Sedation management in mechanically ventilated patients in the ICU is critical for optimizing patient outcomes. This study aimed to evaluate sedation practices and their impact on clinical outcomes in critically ill patients. Methods: A prospective observational research was performed including 196 ICU patients on mechanical ventilation. Demographic information, primary diagnoses, sedation procedures, duration of mechanical breathing, length of stay in the ICU and hospital, and clinical outcomes were documented. sedation was administered in accordance with a standardized protocol including sedatives like propofol, midazolam, and dexmedetomidine. Multivariate regression analysis was conducted to ascertain predictors of ventilation duration. Results: The average age of patients was 62.5 years, with respiratory failure as the predominant diagnosis (43.4%). The mean duration of mechanical ventilation was 7.8 days, accompanied by an intensive care unit stay of 12.5 days and an overall hospital stay of 18.4 days. Mortality was 14.3%, and 20.4% of patients acquired ventilator-associated pneumonia (VAP). Propofol was the predominant sedative utilized (48.5%), succeeded by midazolam (35.7%) and dexmedetomidine (15.8%). Patients administered propofol exhibited the briefest breathing duration, whereas those treated with midazolam demonstrated the most prolonged length. Multivariate regression indicated that age, APACHE II score, adherence to sedation protocols, and dexmedetomidine usage were significant predictors of breathing duration. Delirium and ventilator-associated pneumonia (VAP) were correlated with extended mechanical ventilation. Conclusion: Enhancing sedation techniques, such as compliance with sedation guidelines and judicious application of dexmedetomidine, may decrease the time of mechanical breathing and enhance patient outcomes. Delirium and ventilator-associated pneumonia (VAP) were recognized as significant determinants of extended mechanical ventilation. Additional research is required to enhance sedation protocols for critically ill patients.

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