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CC BY 4.0 · Indian Journal of Neurotrauma 2024; 21(01): 087-089
DOI: 10.1055/s-0043-1762599
Correspondence

Sedation Vacation in Neurocritical Care: A Proposal Algorithm

Luis Rafael Moscote-Salazar
1   Department of Critical Care Medicine, Physician Regional Medical Center, Naples, Florida, United States
,
William A. Florez-Perdomo
1   Department of Critical Care Medicine, Physician Regional Medical Center, Naples, Florida, United States
,
Tariq Janjua 
2   Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
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Abstract

Daily sedation interruption or sedation vacation is a strategy for neurological evaluation, respiratory mechanics, cardiac stability, and eventual weaning to extubation. However, its application has safety aspects such as pulmonary, cardiac, and neurological complications. A protocol-driven sedation vacation in the medical intensive care helps with the reduction in the intensive care length of stay and increase in ventilator-free days.1,2 The same approach can be used in neurointensive care with alterations based upon the neurocritical care progression.

Keywords

critical care - neurocritical care - neurosurgery - neurotrauma - sedation


Publication History

Article published online:
01 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Girard TD, Kress JP, Fuchs BD. et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008; 371 (9607): 126-134
    CrossrefPubMedGoogle Scholar
  • 2 Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 2010; 375 (9713): 475-480
    CrossrefPubMedGoogle Scholar
  • 3 Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000; 342 (20) 1471-1477
    CrossrefPubMedGoogle Scholar
  • 4 Mehta S, Burry L, Cook D. et al; SLEAP Investigators, Canadian Critical Care Trials Group. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA 2012; 308 (19) 1985-1992
    CrossrefPubMedGoogle Scholar
  • 5 Burry L, Cook D, Herridge M. et al; SLEAP Investigators, Canadian Critical Care Trials Group. Recall of ICU stay in patients managed with a sedation protocol or a sedation protocol with daily interruption. Crit Care Med 2015; 43 (10) 2180-2190
    CrossrefPubMedGoogle Scholar