Some patients in the intensive care unit can safely give themselves sedatives to better manage anxiety while on mechanical ventilation, according to a study in the American Journal of Critical Care.
"How to best manage the many symptoms experienced by patients undergoing mechanical ventilation without contributing to adverse ICU-acquired conditions remains a daunting challenge for clinicians," said Linda Chlan, PhD, RN, the study's lead author. "By appropriately empowering patients to self-manage their symptoms, we can help meet their highly individualized needs for sedative therapy to promote comfort."
Researchers piloted the program at three ICUs in Minnesota. They randomly selected 17 intubated patients who could give themselves dexmedetomidine and 20 other patients who received usual care. All patients in the study who were willing to self-manage their sedation were eligible.
The 17 self-managing patients could push a button when they felt anxious, but were allowed up to three presses per hour, with a 20 minute lockout.
The study found self-administering dexmedetomidine is safe during the later part of mechanical ventilation, and patients' ability to control their anxiety with self-administered sedatives was on par with clinicians' ability. Additionally, none of the 17 self-administering patients experienced delirium, while four of the control patients did.