This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements in several important clinical outcomes in critically ill postoperative patients. Given the clinical and economic burden of critical illness, postoperative morbidity, and the substantial number of patients who could benefit from this strategy, increased attention should be given to prevention of postoperative iatrogenic injury potentially induced by unnecessary sedation and mechanical ventilation.

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