Intensive care sedation of mechanically ventilated patients: a national Swedish survey

Sedation in critically ill patients is a complex issue and at the same time an important concept for ensuring patient comfort. The aim of this study was to review the current practice of sedation for patients on mechanical ventilation in Swedish intensive care units (ICUs). Questionnaires were sent by post to head nurses in 89 ICUs with mechanically ventilated patients. By August 2000, 87 (98%) questionnaires had been returned. The results show that mechanically ventilated patients were routinely sedated in 91% of ICUs. Midazolam or propofol in combination with an opioid were the drugs preferred by 76%. Heavy sedation was most usual in 63% of ICUs but, when asked about the sedation level preferred by nurses, 78% chose light sedation (P=0.001). Only 16% used sedation scales. This study indicates that local habits and personal attitudes seem to have a great impact on sedation routines. It therefore appears worthwhile for ICUs to review their practice and, if necessary, to consider implementing sedation scales and sedation guidelines. Research pertaining to potential complications and patient comfort in relation to different sedation levels as well as further validation of the efficacy of sedation scales is needed.