None listed
Conditions
Brief summary
There is abundant observational evidence that midazolam, a benzodiazepine drug used for sedation, use is associated with delirium in ICU patients. However, despite the availability of an equally effective alternative, benzodiazepines usage remains high. The most likely explanation for is that clinicians are not sufficiently convinced by the quality of the observational studies. This is a reasonable criticism, as it is unlikely that it was possible to adjust for all sources of indication bias in these studies. We hypothesise that introducing a clinical guideline for intubated patients in the Austin Hospital ICU that restricts midazolam use to patients with one of a select list of indications will a. reduce the use of midazolam and b. reduce the incidence of surrogate markers of delirium in ICU patients, without c. significantly increasing cost of sedative medications in the ICU.
Interventions
A clinical guideline for intubated patients in the ICU that restricts continuous IV midazolam use to patients with one of a select list of indications: seizures, alcohol withdrawal, requirement for dangerously high doses of other sedatives. The rate of midazolam infusion under these circumstances will be determined by the physician responsible for the patient's ICU management, using standard clinical assessments to measure response, for the duration judged clincially appropriate.
Sponsors
Austin Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All mechanically ventilated patients admitted to the ICU in the study period
Exclusion criteria
None
Outcome results
None listed