Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Drs Galen and Siegel; Benjamin.Galen@yale.edu).
To the Editor: Although both strategies studied in the recent trial by Dr Mehta and colleagues1 have been shown to be superior to liberal sedation methods,2 we believe both groups may have received more sedation than necessary. The approach to intensive care unit sedation has long operated under the assumption that sedation is required for patients who are mechanically ventilated, a presupposition we believe is incorrect. A recent study questioned this assumption by showing that patients managed without routine sedation spent less time on the ventilator and in the hospital compared with those managed with sedative infusions.3
Galen BT, Siegel MD. Sedation Interruption for Mechanically Ventilated Patients. JAMA. 2013;309(10):981-982. doi:10.1001/jama.2013.1004