August 1, 2013
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This was a comprehensive, interdisciplinary, 2-year quality improvement project to reduce continuous sedation infusions and improve the recognition and prevention of delirium in patients with acute lung injury. It resulted in less infusion use, more days per patient without sedation, and more patient days awake and not delirious, although the median proportion of days with delirium per patient actually increased.
In this study, closed-loop, titrated pressure support ventilation was associated with a significantly shorter time course until patients passed a spontaneous breathing trial and were successfully extubated compared to a standardized weaning protocol.
This large, multicenter, quality improvement project showed a dramatic reduction in mortality among patients with severe sepsis or septic shock after implementation of a sepsis treatment bundle.
In mechanically ventilated ICU patients, availability of music via headphones resulted in a greater reduction in anxiety and sedation exposure.