Pharmacist-developed sedation protocol and impact on ventilator days

Up to one-third of intensive care unit (ICU) patients require mechanical ventilation. Mechanical ventilation is associated with numerous complications including ventilator-induced lung injury and gastrointestinal bleeding due to ulcerations.(1) Sedation protocols are used in order to optimize treatment and decrease days spent on mechanical ventilation.

The purpose of this trial is to evaluate the effectiveness of an ICU sedation protocol. The primary end point was days on mechanical ventilation.

A retrospective chart review was performed. The medical records of 21 patients treated prior to the protocol and 21 patients treated after protocol implementation were reviewed.

The duration of mechanical ventilation was decreased in the postprotocol patients compared to the preprotocol patients. The mean duration of mechanical ventilation in the preprotocol group was 6.39 ± 5.24 versus the postprotocol group which was 3.78 ± 3.21 days. After implementing the sedation protocol, the number of days to extubation was decreased by 2.61 days.

The use of sedation protocols can decrease the days spent on mechanical ventilation. The results also illustrate the enormous impact pharmacists have on policy and protocol development.