• Helene Korvenius Nedergaard, Serkan Korkmaz, Hanne Tanghus Olsen, Hanne Irene Jensen, Thomas Strøm, and Palle Toft.
• Department of Anesthesiology and Intensive care, University Hospital of Southern Denmark, Kolding. Sygehusvej 24, DK-6000 Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Winsløwsparken 19, 3., DK-5000 Odense C, Denmark. Electronic address: helene.korvenius.nedergaard@rsyd.dk.
• J Crit Care. 2022 Apr 1; 68: 66-71.

PurposeThere is a growing awareness on minimizing sedation in ICUs. In the NONSEDA trial 700 critically ill patients were randomized to light sedation or non-sedation during mechanical ventilation. Approximately 40% of patients randomized to non-sedation needed sedation. The aim of this study is to obtain knowledge on patients, who experienced failure of non-sedation.Materials And MethodsThis study is a retrospective post-hoc analysis of the NONSEDA trial. Patients, who were randomized to non-sedation are sub-divided into those who did not require sedation during mechanical ventilation ("non-sedation success"), and those who needed continuous sedation at least once ("non-sedation failure").Results348 patients were randomized to non-sedation, 199 experienced non-sedation success, whereas 149 experienced non-sedation failure. Patients in the two groups were comparable with regards to age, BMI, disease severity scores and admission diagnoses. Patients with non-sedation failure were more often male. Propofol was mainly used as rescue sedation. Patients with non-sedation failure had less days alive without sedation, coma, delirium, organ support, mechanical ventilation, ICU- and hospital admission. Mortality and long-term outcomes did not differ between groups.ConclusionPatients with non-sedation success had better in-hospital outcomes, but mortality and long-term outcomes were not affected by success or failure of non-sedation.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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