In our center, using a strict sedation protocol, sedation requirements were already sharply declining before tracheotomy was performed.
The VAP care bundles consisted of weaning according to weaning protocol, sedation vacation, head-of-bed elevation, measurement of cuff pressures four times/day, 2% chlorhexidine use for mouth care and emptying of ventilator circuit condensate.
Among the variables tested (hospital type, use of a local nutrition protocol, sedation, vasoactive drugs, number of interruptions of enteral nutrition and measurement of gastric residual volume), only measurement of residual volume was significant by univariate analysis.
Computerized Physician Order Entry (CPOE) analgesia-sedation protocols may improve sedation practice and patients' outcomes.
However, in ICUs with very high staff levels, protocols of sedation may not be necessary [19].
However, in ICUs with very high staff levels, protocols of sedation may not be necessary [ 19].
The median duration of mechanical ventilation was significantly shorter in patients managed with protocol-directed sedation compared with patients receiving non-protocol-directed sedation (55.9 vs 117 hours, P = 0.008).
Brook and coworkers [ 24] compared the practice of protocol-directed sedation during mechanical ventilation implemented by nurses versus traditional non-protocol-directed administration of sedation.
In a randomized controlled trial including 321 patients [ 137], Brook and colleagues compared a practice of protocol-directed sedation during mechanical ventilation implemented by nurses with traditional non-protocol-directed sedation administration.
Patients in the protocol-directed sedation group also had a significantly lower tracheostomy rate than did those in the non-protocol-directed sedation group.
