Both SAT and SBT
Spontaneous Awakening Trials (SATs), also known as daily sedative interruptions, are one of the recommended titration methods in the recent Pain, Agitation, Delirium, Immobility, and Sleep Disruption (PADIS) guidelines for managing sedatives in critically ill patients and achieving light sedation. Daily SATs are the stopping of narcotics (as long as pain is controlled) and sedatives every day and, if needed, restarting either narcotics or sedatives at half the previous dose and titrating as needed. The ABC study, also known as the Wake Up and Breathe study, showed that pairing together daily SATs with daily Spontaneous Breathing Trials (SBTs) in a protocol that included safety screens and failure criteria resulted in improved patients outcomes (i.e., decreased time on the ventilator, reduced time spent in the ICU and hospital, and improved one-year survival).
This coordination of SATs and SBTs (awakening and breathing trials) emphasizes that narcotic and sedation titration alongside timely removal of mechanical ventilation play a pivotal role in liberating patients from the ICU and are thus core features of the ABCDEF bundle.
Wake Up and Breathe Flowchart
Spontaneous Awakening Trials (SATs) + Spontaneous Breathing Trials (SBTs)
2018 PADIS SCCM/ACCP Guidelines
(formerly known as PAD guidelines)