Yiliaz Canan, Kelebek Girgin Nermin, Ozdemir Nurdan, Kutlay Oya
Department of Anaesthesiology and Reanimation, Uludağ University, Faculty of Medicine, Bursa, Turkey.
Ulus Travma Acil Cerrahi Derg. 2010 Nov;16(6):521-6.
We aimed to compare the effects of nursing-implemented sedation protocol and daily interruption of sedative infusion on the duration of mechanical ventilation.
Fifty patients receiving mechanical ventilation and requiring sedation in the intensive care unit (ICU) were randomly selected to receive either daily interruption of sedative infusion (Group P, n=25) or nursing-implemented sedation protocol (Group N, n=25). In Group P, daily interruption of sedative infusions without any sedation protocol was performed by physicians. In Group N, nursing-implemented sedation protocol prepared by physicians was applied. In this group, if the ideal level of sedation was not achieved, information was given by nurses to physicians. Patients in each group were compared according to demographic variables, duration of mechanical ventilation and sedation, length of stay in the ICU, and mortality.
Demographic variables, length of stay in the ICU and mortality were similar between the two groups. In Group P, duration of sedation and mechanical ventilation were significantly shorter than in Group N. Light sedation was seen more frequently in Group P and deep sedation in Group N.
Daily interruption of sedative infusions provided shorter duration of sedation and mechanical ventilation than nursing-implemented sedation with protocol. Although nurse-implemented sedation protocol has been found acceptable, if the number of nurses is lacking, we believe the nurse-implemented sedation protocol should not be applied.
我们旨在比较护理实施的镇静方案和每日中断镇静剂输注对机械通气持续时间的影响。
在重症监护病房（ICU）中随机选择50例接受机械通气且需要镇静的患者，分别接受每日中断镇静剂输注（P组，n = 25）或护理实施的镇静方案（N组，n = 25）。在P组中，由医生进行每日中断镇静剂输注，且无任何镇静方案。在N组中，应用医生制定的护理实施的镇静方案。在该组中，如果未达到理想的镇静水平，护士会向医生提供信息。根据人口统计学变量、机械通气和镇静持续时间、在ICU的住院时间以及死亡率对每组患者进行比较。
两组之间的人口统计学变量、在ICU的住院时间和死亡率相似。在P组中，镇静和机械通气的持续时间明显短于N组。P组中浅镇静更为常见，N组中深镇静更为常见。
与按照方案进行的护理实施镇静相比，每日中断镇静剂输注可缩短镇静和机械通气的持续时间。尽管已发现护士实施的镇静方案是可接受的，但如果护士数量不足，我们认为不应应用护士实施的镇静方案。
