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Objectives:

In the absence of a universal definition of light or deep sedation, the level of sedation that conveys favorable outcomes is unknown. We quantified the relationship between escalating intensity of sedation in the first 48 hours of mechanical ventilation and 180-day survival, time to extubation, and delirium.

Design:

Harmonized data from prospective multicenter international longitudinal cohort studies

Setting:

Diverse mix of ICUs.

Patients:

Critically ill patients expected to be ventilated for longer than 24 hours.

Interventions:

Richmond Agitation Sedation Scale and pain were assessed every 4 hours. Delirium and mobilization were assessed daily using the Confusion Assessment Method of ICU and a standardized mobility assessment, respectively.

Measurements and Main Results:

Sedation intensity was assessed using a Sedation Index, calculated as the sum of negative Richmond Agitation Sedation Scale …