Tags

Type your tag names separated by a space and hit enter

A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients.
Crit Care Med. 2006 May; 34(5):1326-32.CC

Abstract

OBJECTIVE

To compare duration of mechanical ventilation for patients randomized to receive lorazepam by intermittent bolus administration vs. continuous infusions of propofol using protocols that include scheduled daily interruption of sedation.

DESIGN

A randomized open-label trial enrolling patients from October 2001 to March 2004.

SETTING

Medical intensive care units of two tertiary care medical centers.

PATIENTS

Adult patients expected to require mechanical ventilation for >48 hrs and who required > or =10 mg of lorazepam or a continuous infusion of a sedative to achieve adequate sedation.

INTERVENTIONS

Patients were randomized to receive lorazepam by intermittent bolus administration or propofol by continuous infusion to maintain a Ramsay score of 2-3. Sedation was interrupted on a daily basis for both groups.

MEASUREMENTS AND MAIN RESULTS

The primary outcome was median ventilator days. Secondary outcomes included 28-day ventilator-free survival, intensive care unit and hospital length of stay, and hospital mortality. Median ventilator days were significantly lower in the daily interruption propofol group compared with the intermittent bolus lorazepam group (5.8 vs. 8.4, p = .04). The difference was largest for hospital survivors (4.4 vs. 9.0, p = .006). There was a trend toward greater ventilator-free survival for patients in the daily interruption propofol group (median 18.5 days for propofol vs. 10.2 for lorazepam, p = .06). Hospital mortality was not different.

CONCLUSIONS

For medical patients requiring >48 hrs of mechanical ventilation, sedation with propofol results in significantly fewer ventilator days compared with intermittent lorazepam when sedatives are interrupted daily.

Authors+Show Affiliations

Division of Pulmonary and Critical Care, Department of Medicine, University of North Carolina at Chapel Hill, 4134 Bioinformatics Building, Chapel Hill, NC 27599-7020, USA. scarson@med.unc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16540958

Citation

Carson, Shannon S., et al. "A Randomized Trial of Intermittent Lorazepam Versus Propofol With Daily Interruption in Mechanically Ventilated Patients." Critical Care Medicine, vol. 34, no. 5, 2006, pp. 1326-32.
Carson SS, Kress JP, Rodgers JE, et al. A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients. Crit Care Med. 2006;34(5):1326-32.
Carson, S. S., Kress, J. P., Rodgers, J. E., Vinayak, A., Campbell-Bright, S., Levitt, J., Bourdet, S., Ivanova, A., Henderson, A. G., Pohlman, A., Chang, L., Rich, P. B., & Hall, J. (2006). A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients. Critical Care Medicine, 34(5), 1326-32.
Carson SS, et al. A Randomized Trial of Intermittent Lorazepam Versus Propofol With Daily Interruption in Mechanically Ventilated Patients. Crit Care Med. 2006;34(5):1326-32. PubMed PMID: 16540958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients. AU - Carson,Shannon S, AU - Kress,John P, AU - Rodgers,Jo Ellen, AU - Vinayak,Ajeet, AU - Campbell-Bright,Stacy, AU - Levitt,Joseph, AU - Bourdet,Sharya, AU - Ivanova,Anastasia, AU - Henderson,Ashley G, AU - Pohlman,Anne, AU - Chang,Lydia, AU - Rich,Preston B, AU - Hall,Jesse, PY - 2006/3/17/pubmed PY - 2006/5/18/medline PY - 2006/3/17/entrez SP - 1326 EP - 32 JF - Critical care medicine JO - Crit Care Med VL - 34 IS - 5 N2 - OBJECTIVE: To compare duration of mechanical ventilation for patients randomized to receive lorazepam by intermittent bolus administration vs. continuous infusions of propofol using protocols that include scheduled daily interruption of sedation. DESIGN: A randomized open-label trial enrolling patients from October 2001 to March 2004. SETTING: Medical intensive care units of two tertiary care medical centers. PATIENTS: Adult patients expected to require mechanical ventilation for >48 hrs and who required > or =10 mg of lorazepam or a continuous infusion of a sedative to achieve adequate sedation. INTERVENTIONS: Patients were randomized to receive lorazepam by intermittent bolus administration or propofol by continuous infusion to maintain a Ramsay score of 2-3. Sedation was interrupted on a daily basis for both groups. MEASUREMENTS AND MAIN RESULTS: The primary outcome was median ventilator days. Secondary outcomes included 28-day ventilator-free survival, intensive care unit and hospital length of stay, and hospital mortality. Median ventilator days were significantly lower in the daily interruption propofol group compared with the intermittent bolus lorazepam group (5.8 vs. 8.4, p = .04). The difference was largest for hospital survivors (4.4 vs. 9.0, p = .006). There was a trend toward greater ventilator-free survival for patients in the daily interruption propofol group (median 18.5 days for propofol vs. 10.2 for lorazepam, p = .06). Hospital mortality was not different. CONCLUSIONS: For medical patients requiring >48 hrs of mechanical ventilation, sedation with propofol results in significantly fewer ventilator days compared with intermittent lorazepam when sedatives are interrupted daily. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/16540958/A_randomized_trial_of_intermittent_lorazepam_versus_propofol_with_daily_interruption_in_mechanically_ventilated_patients_ L2 - https://dx.doi.org/10.1097/01.CCM.0000215513.63207.7F DB - PRIME DP - Unbound Medicine ER -