New Method Cuts Patient Ventilator Time

Stopping sedation so ICU patients wake up before their ability to breathe on their own is tested gets them off ventilators sooner, say U.S. researchers.

Numbers on the monitor in the ICU aren’t very good at predicting if a patient is ready to come off a ventilator, said Timothy Girard, lead author of the study. In the past, the process of turning sedation drugs off has been done separately from turning off the ventilator. Our study proved that if we connect these two processes, it will safely allow patients to come off the ventilator earlier.

Girard, Wes Ely and colleagues at Vanderbilt University Medical Center in Nashville led a multicenter study of 335 intensive care unit patients on mechanical ventilation.

Half were treated with the team’s Wake Up and Breathe protocol and were allowed to come out of sedation before spontaneous breathing trials were performed. The other half had their ventilators turned off for their spontaneous breathing trials while they were still sedated.

Patients on Wake Up and Breathe came off the ventilator an average of three days earlier than the standard-care group, were discharged from the ICU and hospital an average of four days earlier, and their death rate during the 28-day study was slightly lower than the standard-care group.

The study is being presented this week at the annual meeting of the American Thoracic Society in San Francisco.