• Milagros I Figueroa-Ramos, Carmen Mabel Arroyo-Novoa, Geraldine Padilla, Pablo Rodríguez-Ortiz, Bruce A Cooper, and Kathleen A Puntillo.
• University of Puerto Rico, Medical Sciences Campus, School of Nursing, Puerto Rico. milagros.figueroa@upr.edu
• Intensive Crit Care Nurs. 2013 Feb 1;29(1):20-7.

ObjectivesTo determine the feasibility of conducting a sedation wake-up trial (SWT) plus a spontaneous breathing trial (SBT) in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients' physiological responses; and to maintain patient safety.MethodsA secondary analysis of the intervention group from a trial of 20 mechanically ventilated patients receiving SWT plus SBT in a trauma-intensive care unit.ResultsPatients passed 67% of the 39 SWTs performed; those who failed presented RASS scores of +1 and +2 (70%), tachycardia (15%) or ventilator asynchrony (15%). Eighteen patients tolerated their first SBT, and after the second SBT, more than half of the patients were discontinued from the mechanical ventilator. A significant increase from the beginning to the end of the SWT was found in heart rate (p=.021), respiratory rate (p=.043) and systolic blood pressure (p=.04). Although these measures increased significantly, their overall mean did not increase by 20%.ConclusionSWT plus SBT was well tolerated and successfully implemented. Our data showed that it is not necessary to withhold continuous-infusion analgesia during the SWT.Copyright © 2012 Elsevier Ltd. All rights reserved.

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