Khan, Babar A.Fadel, William F.Tricker, Jason L.Carlos, W. GrahamFarber, Mark O.Hui, Siu L.Campbell, Noll L.Ely, E. WesleyBoustani, Malaz A.2016-11-222016-11-222014-12Khan, B. A., Fadel, W. F., Tricker, J. L., Carlos, W. G., Farber, M. O., Hui, S. L., … Boustani, M. A. (2014). Effectiveness of Implementing a Wake up and Breathe Program on Sedation and Delirium in the Intensive Care Unit. Critical Care Medicine, 42(12), e791–e795. http://doi.org/10.1097/CCM.00000000000006601530-0293https://hdl.handle.net/1805/11488OBJECTIVES: Mechanically ventilated critically ill patients receive significant amounts of sedatives and analgesics that increase their risk of developing coma and delirium. We evaluated the impact of a "Wake-up and Breathe Protocol" at our local ICU on sedation and delirium. DESIGN: A pre/post implementation study design. SETTING: A 22-bed mixed surgical and medical ICU. PATIENTS: Seven hundred two consecutive mechanically ventilated ICU patients from June 2010 to January 2013. INTERVENTIONS: Implementation of daily paired spontaneous awakening trials (daily sedation vacation plus spontaneous breathing trials) as a quality improvement project. MEASUREMENTS AND MAIN RESULTS: After implementation of our program, there was an increase in the mean Richmond Agitation Sedation Scale scores on weekdays of 0.88 (p < 0.0001) and an increase in the mean Richmond Agitation Sedation Scale scores on weekends of 1.21 (p < 0.0001). After adjusting for age, race, gender, severity of illness, primary diagnosis, and ICU, the incidence and prevalence of delirium did not change post implementation of the protocol (incidence: 23% pre vs 19.6% post; p = 0.40; prevalence: 66.7% pre vs 55.3% post; p = 0.06). The combined prevalence of delirium/coma decreased from 90.8% pre protocol implementation to 85% postimplementation (odds ratio, 0.505; 95% CI, 0.299-0.853; p = 0.01). CONCLUSIONS: Implementing a "Wake Up and Breathe Program" resulted in reduced sedation among critically ill mechanically ventilated patients but did not change the incidence or prevalence of delirium.en-USPublisher PolicyCritical IllnessDeep SedationmethodsDeliriumprevention & controlRespirationRespiration, ArtificialArticle