A Systematic Review: The Effect of Continuous Sedation Versus Interruption of Sedation on the Incidence of Delirium in Adult Intensive Care Unit Patients with Mechanical Ventilation

Tuesday, July 12, 2011: 10:30 AM

Yin Yin Tsou, MS
Nursing department, Taipei Veterans General Hospital, Taipei, Taiwan

Learning Objective 1: The learner will be able to understand how to practice with evidence-based nursing in clinical care.

Learning Objective 2: The learner will be able to reconsider whether continuous sedation is only way to relieve critical patients' pain.

Purpose: To assess the effect of continuous sedation versus interruption of sedation on the incidence of delirium in adult
intensive care unit patients with mechanical ventilation.

Methods: We search the databases(the Cochrane library, MEDLINE, CINHAL and PsycINFO), supplemented by a
manual review of bibliographies of identified articles and discussion with recognized content experts.
Selection Criteria: All randomised controlled trials involving adult ventilated patients were undertaken. The intervention
was a interruption of sedationand the control intervention was continuous sedation. The outcome was the incidence of
delirium based on the Diagnostic and Statistical Manual of Mental Disorders or WHO ICD-10 classification criteria for
delirium. A critical appraisal and data extraction were performed by two reviewers.

Results: Two randomized controlled trials were identified. Only one study (336 participants) discussed the incidence of
delirium and reported no significant difference between the two study groups. Regarding length of hospital stay, one
study reported no difference between the two groups while the second study showed the intervention group was
discharged earlier than the control group.

Conclusion: There was insufficient evidence to draw firm conclusions about the positive effects of the interruption of
sedation in either the incidence of delirium or the length of stay in hospital. More high quality research is needed in order
to answer this research question