„Light sedation" strategy vs. deep sedation in mechanically ventilated patients
An analysis of clinical outcomes and safety
DOI:
https://doi.org/10.12775/QS.2026.56.71953Keywords
light sedation, deep sedation, mechanical ventilation, intensive care unit, mortality, delirium, Richmond Agitation-Sedation Scale (RASS)Abstract
Background. Sedation management is a cornerstone of supportive care for critically ill
patients
receiving mechanical ventilation. While deep sedation was historically the standard,
contemporary practices are shifting toward an "eCASH" model (Comfort and patient-centered
Care without excessive Sedation and High levels of analgesia).
Aim. The objective of this study was to comprehensively evaluate and compare clinical
outcomes between light sedation and deep sedation strategies in mechanically ventilated
patients, focusing on mortality rates, duration of mechanical ventilation, length of stay (LOS),
and neurological complications.
Material and methods. A detailed analysis was performed based on 40 scientific sources,
including randomized controlled trials and meta-analyses. Sedation depth was primarily
defined using the Richmond Agitation-Sedation Scale (RASS).
Results. Early deep sedation (within 48 hours) is an independent predictor of increased
mortality (Hazard Ratio = 1.661). Light sedation was associated with a reduction in
mechanical ventilation duration by an average of 2.1 days and shorter ICU stays by 3 days.
Conclusions. Targeting light sedation should be the default standard of care to improve
patient survival and recovery, as deep sedation is a strong predictor of delirium and increased
mortality.
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