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March 13, 2013

Sedation Interruption for Mechanically Ventilated Patients—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Medicine (Dr Mehta; and Department of Pharmacy and Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Burry); Departments of Medicine, Clinical Epidemiology & Biostatistics, St Joseph's Healthcare, Hamilton, Ontario, Canada (Dr Cook).

JAMA. 2013;309(10):982-983. doi:10.1001/jama.2013.1007

In Reply: Drs Brun-Bruisson and Schortgen question the generalizability of our results to units with different staffing models. The nurse-to-patient ratio in enrolling centers ranged from 1:1 to 1:2 and was not altered for the trial. Sedation monitoring occurred hourly for the first 7 days and every 2 hours thereafter. Administration of the Sedation-Agitation scale or the Richmond Agitation Sedation scale takes less than 1 minute to perform and can be performed concurrently with other nursing care. Regarding workload, the mean visual analog scale administered by the nurses was similar on study days 1 through 2 compared with days 3 through 7 in both the daily sedation interruption (4.35 vs 4.34) and sedation protocol group (3.96 vs 3.97).

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