Weaning from mechanical ventilation and sedation.

Alawi Luetz, Anton Goldmann, Steffen Weber-Carstens, Claudia Spies

Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitaetsmedizin Berlin, Berlin, Germany.

Current opinion in anaesthesiology 2012 Apr

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Guidelines for weaning from sedation and weaning from ventilator gained increasing interest in recent years. This includes patients with acute respiratory distress syndrome, as well as other mechanically ventilated patients. This review will give an overview of the current literature and practice guidelines in ventilator and sedation weaning. Sedation and ventilator weaning are closely linked. Weaning protocols for both sedation and ventilator weaning should be implemented in daily routine. The essential element of such algorithm should be a daily spontaneous awakening trial and spontaneous breathing trial. Furthermore, regularly monitoring for deepness of sedation and delirium should be implemented. Too deep sedation, as well as prolonged delirium is associated with higher mortality. The most important conclusion we come to from recent randomized controlled trials is that only using an integrative algorithm for sedation and ventilator weaning can improve survival of ICU patients.

Citation

Alawi Luetz, Anton Goldmann, Steffen Weber-Carstens, Claudia Spies. Weaning from mechanical ventilation and sedation. Current opinion in anaesthesiology. 2012 Apr;25(2):164-9