In mechanically ventilated adults patients, are daily sedation breaks compared to a continuous sedation, more efficient in reducing the ventilated days and length of ICU stay?

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ACKNOWLEDGEMENTS

This dissertation is an opportunity for me to extend my regards to my research supervisor, my beloved friends, and my family for their untiring support that they furnished throughout my research. I am grateful to them for their belief in me and the guidance that they provided me without which I would have never been able to work on and complete this research. It also signifies my own views and does not closely relate to the university.

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DECLARATION

I, (Your name), would like to declare that all contents included in this study stand for my individual work without any aid, and this proposal has not been submitted for any examination at academic as well as professional level, previously. It is also represents my very own views and not essentially those that are associated with other university.

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ABSTRACT

Introduction: The continuous infusion of the sedative agents is usually necessary for the adult patients who are critically ill in the ICU. The aim of this study was, therefore, to investigate and determine whether the use of continuous sedation and daily sedation breaks is associated with prolongation of the duration of mechanical ventilation and reduction in the length of ICU stay. However the continuous sedation is linked to a variety of disadvantages. Diverse range of interventions reduces the risks that have been evaluated including the interrupting sedative infusions practice on a regular basis and the nurse led sedation protocol to reduce rates of mortality.

Method: For this purpose a secondary research was conducted from a variety of databases such as COHRANE library, CINHAL plus with full text, MEDLINE, and the EMBASE from the year 2000- 2012. Full text papers were included in this study. They were reviewed again and again to find various studies involved in evaluating the effectiveness and safety of daily sedation breaks and its outcomes, study aims, design, findings, including various outcomes such as duration of mechanical ventilation, length of stay in hospital was determined.

Findings: The daily sedation breaks implementation was suggested to minimize the multiple complications linked with the continuous sedatives administration and they were not connected with the long term psychological effects and intensive care related complications. Additionally the randomized controlled trials enrol larger and more varied samples which are required to offer more evidences regarding the effectiveness of the nurse led sedation protocol.

Conclusion: The utmost quality evidence suggests daily sedation breaks inclusion is beneficial. Sedation practice is likely to powerfully influence costs of health care and improving practice of sedation which may not only benefit patients but also reduce the duration of mechanical ventilation.

Table of Contents

ACKNOWLEDGEMENTSi

DECLARATIONii

ABSTRACTiii

CHAPTER 1: INTRODUCTION1

Purpose of the study1

Background of the study1

Significance of the study2

PICO question3

CHAPTER 2: METHODOLOGY5

Evidence based practice (EBP)6

Qualitative Design6

Justification of using the Qualitative design7

Inclusion and Exclusion Criteria8

Inclusion criteria8

Exclusion criteria9

CHAPTER 3: REVIEW OF THE LITERATURE10

Introduction10

Over view of Mechanical ventilation11

Objectives Mechanical Ventilation12

Methods of weaning from mechanical ...