Lancet Respir Med

Deep sedation during ventilation linked to loss of independence post-ICU

October 17, 2025

Study details: A retrospective cohort study of 10,204 adults who were living independently prior to admission and required ≥24 hours of mechanical ventilation across 20 ICUs in New York evaluated the association between the proportion of time spent in medication-induced deep sedation (Richmond Agitation Sedation Score -3 to -5) and emotional distress during the first ICU week, with loss of independent living (in-hospital death or discharge to long-term care) as the primary outcome.

Results: A high proportion of deep sedation was independently associated with increased risk of loss of independent living (adjusted risk ratio [RR], 1.18; 95% confidence interval [CI], CI 1.13–1.23; p<0.0001). In contrast, a high proportion of emotional distress was associated with decreased risk (adjusted RR, 0.88; 95% CI, 0.84–0.92; p<0.0001). Absence of patient mobility mediated 32.5% of the effect of deep sedation on loss of independence. Symptom control with antipsychotics or non-opioid analgesics reduced risk compared with no treatment.

Clinical impact: Minimizing deep sedation and promoting patient mobility during mechanical ventilation may reduce loss of independence post-ICU. These findings reinforce guideline recommendations to target light sedation and avoid unnecessary deep sedation in mechanically ventilated patients.

Source:

Wongtangman K, et al; ICU Sedation Collaborators. (2025, October 11). Lancet Respir Med. Association of medication-induced deep sedation and emotional distress during mechanical ventilation with loss of independent living: an observational cohort study. https://pubmed.ncbi.nlm.nih.gov/41086817/