The main findings of this prospective, international, multicentric, observational study are as follows: (1) 68% (3,540 of 5183 patients receiving mechanical ventilation) received a sedative at any time while receiving mechanical ventilation; (2) the persistent use of sedatives was associated with more days of mechanical ventilation, more weaning days, and longer length of stay in the ICU; (3) NMBs were used in 13% (686 of 5,183 patients); and (4) patients requiring NMB has a longer duration of mechanical ventilation, weaning time, ICU stay, and higher mortality.
The use of sedatives and analgesics are very common in the ICU; however, the frequency of use of these medications is not well known. Bertolini et al found that 60% of 2,932 patients admitted to 128 adult, general ICUs received a sedative or analgesic. The most common sedatives were propofol (40%) and diazepam (34%); the most common analgesics were fentanyl (36%) and morphine (22%). In their patients, the prevalence of sedation tends to decrease linearly overtime. Unfortunately no data of outcomes were described in this study. Similarly to Bertolini et al, we found that 68% of our patients received a sedative at any moment during the ICU stay. Most of the patients received the sedative for a short period of time, and two thirds (67%) received a combination of drugs, more commonly benzodiazepines and opiates. Patients who received sedatives had longer time on mechanical ventilation, a longer weaning period, and a longer ICU stay.