Sedation holiday
Formal Definition
A daily protocol of interrupting continuous sedative infusions in mechanically ventilated ICU patients to allow the patient to wake to a defined level of alertness — used to assess neurological status, reduce sedative accumulation, and facilitate ventilator weaning.
How It's Used on the Ward
"Sedation holiday time" or "waking her up" — the daily ICU ritual of turning off the propofol and assessing what you have.
Example
""Day 6 on the vent: sedation holiday at 8am — turned off propofol and fentanyl. Patient awoke to voice within 15 minutes, following commands, GCS 11. Passed the SAT. Spontaneous breathing trial started: pressure support 8/5, FiO2 0.4. Tolerating well for 45 minutes — extubation planned for this afternoon.""
Clinical Context
The daily sedation interruption (SAT — spontaneous awakening trial) is one half of the ABC bundle (SAT + SBT — spontaneous breathing trial). The ABCDEF bundle (Assess, Breathe, Coordination, Delirium, Early mobility, Family) has reduced ICU days, ventilator days, and mortality in multiple trials. Overly deep sedation (RASS -3 to -5) is associated with: longer vent duration, ICU delirium, weakness, PTSD. Target light sedation (RASS -1 to 0) whenever possible. The holiday reveals: neurological function, pain level, cooperation for extubation.
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