Korean J Crit Care Med.  2014 Nov;29(4):281-287. 10.4266/kjccm.2014.29.4.281.

Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation

• Lee JM
• Lee SH
• Kwak SH
• Kang HH
• Lee SH
• Lim JM
• Jeong MA
• Lee YJ
• Lim CM

• KMID: 2227735
• DOI: http://doi.org/10.4266/kjccm.2014.29.4.281

Abstract

BACKGROUND
A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV).
METHODS
A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration.
RESULTS
Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups.
CONCLUSIONS
Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.

Keyword

mechanical ventilation; morphine; remifentanil; ventilator weaning

MeSH Terms

Analgesics
Humans
Critical Care
Morphine*
Mortality
Respiration, Artificial*
Ventilation
Ventilator Weaning
Weaning*
Analgesics
Morphine

Figure

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  Fig. 1. Algorithm showing the analgesic or sedative drug use during the weaning period.

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  Fig. 2. Ventilator setting guideline during weaning period.

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  Fig. 3. Kaplan-Meier curves for the weaning of all patients (A) and for only those who had a weaning time of less than 7 days (B).

Reference

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