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Complications of sedation interruption in mechanically ventilated patients: a retrospective observational cohort study
Bandíková, Nikola ; Duška, František (advisor) ; Kieslichová, Eva (referee)
This thesis focuses on the strategy of daily sedation interruptions, as one of the approaches to minimizing complications of sedation in mechanically ventilated patients in intensive care units. The theoretical part summarizes the rationale and evolution of sedation over time as well as the evolution of the concept of daily sedation vacation. The practical part is a cross-over cohort study in which we processed record-level retrospective data from a clinical information system and compared the incidence of several a priori defined complications during the period of sedation interruption and a control period of the same duration in the same patient. We compared 269 sedation interruption periods (median duration of 14.9 hours [interquartile range 5.7-31.9]) and the same number of equally long control periods in 111 patients. The following complications occurred during sedation interruption vs. during control period: inadvertent extubation 0 vs 1, other tubes removal 1 vs 2, fall 0 vs 0, desaturation 33 vs. 23 (p=0,12), tachycardia 10 vs. 6 (p=0,3), hypertension 8 vs. 9 (p=0,8) and hypotension 13 vs. 22 (p=0,01). We also compared proportions of time spent in physiological functions deteriorations between studied periods with the following results: desaturation 0.20 % vs 0.16 % (p=0.11), tachycardia...
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