Liberation from Sedation and Mechanical Ventilation in the Critically Ill Patient

Abstract

Mechanical ventilation is a common life saving treatment modality for the critically ill patients. For patients to tolerate the discomfort, invasive procedures, and anxiety, infusions of sedatives and analgesia are administered. These infusions can cause major complications if given over a prolonged period of time. These include inability to wean from the ventilator, development of ventilator associated events such as pneumonia, pneumothorax, acute respiratory distress syndrome (ARDS), and 2 common iatrogenic complications which include delirium and ICU acquired weakness. These complications contribute significantly to increased cost, length of stay, morbidity, and mortality. To prevent these complications, a novel interprofessional approach has been proposed called the ABCDEF bundle. These incorporate evidence-based approaches on early sedation washout called spontaneous awakening trials (SATs), ventilator weaning called spontaneous breathing trials (SBTs), and early ambulation, best choice of analgesia and sedation, and family involvement. This study will focus on 2 aspect of this bundle which is performing daily SATs and SBTs. The outcome measured will be decreased ventilator length of stay.

Language

English

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Level of Degree

Doctoral

First Committee Member

Christine DeLucas

Second Committee Member

Stephanie Sanderson

Keywords

liberation, mechanical ventilation, early mobility, breathing trials, awakening trials

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