NEJM: Effect of mild sedation or non-sedation on mortality in ICU ventilation patients

In patients with severe mechanical ventilation, daily sedative interruption treatment can shorten ventilation time and ICU hospitalization timeRecently, researchers compared the effects of sedation-free and mild sedation on patient mortalityICU mechanical ventilation patients were randomly treated with non-sedative (non-sedative group) or mild sedation, the standard of mild sedation is: the level of the patient's wake-up, THE RASS score is -2 to -3 points, the mild sedation group is interrupted dailyThe main endpoint of the study was a 90-day mortality rateSecondary endpoints arethrombosisevents, no coma or delirium days, acute kidney injury, no ICU days, and no ventilator daysA total of 700 patients were involved in the study, with similar baseline characteristicsThe average RASS score for the non-sedating group increased from -1.3 on day 1 to -0.8 on day 7, and the sedation group increased from -2.3 on day 1 to -1.8 on day 7The 90-day mortality rate in the non-sedation group was 42.4%, and the sedation group was 37.0% (5.4%)There was no significant difference in the number of days without ICU and the number of days without ventilators between the groupsThe average number of days without coma or delirium in the non-sedative group was 27 days, and the sedation group was 26 daysSevere thrombosis events (difference of -2.5%) occurred in 1 case (0.3%) and 10 (2.8%) in the non-sedation groupthere was no significant difference in mortality rates between the 90-day mortality rate between the mild sedative groups without sedation or daily interruption in patients with mechanical ventilation in the ICU