Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation

ncbi.nlm.nih.gov June 1, 2019

Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role on adherence to light sedation levels. Board-certified intensivists on morning and afternoon shifts were associated with an increased number of patients achieving lighter sedation goals. These findings reinforce the importance of organizational factors, such as intensivists’ presence, as a modifiable quality improvement target. We included 5719 patients. Only 1710 (29.9%) were on target sedation levels on day 2. This study is a secondary analysis of a multicenter two-phase study (prospective cohort followed by a cluster-randomized controlled trial) performed in 118 Brazilian ICUs.