Some attendings push for this on nearly every patient even though it is clear that the patient will not be taken off mechanical ventilation the day of the "vacation." Now with JAMA study how do you guys feel about this. in addition do sedation vacations in themselves reduce VAP? How? If folks arent gettng off the vent quicker buy have daily termnation of vacation how does this strategy work. Personally all the thrashing, tachycardia, tachpnea, hypertension, and further increased work of breathing on folks who already dont look clinically or physiologically ready for extubation makes application of this principle to ALL patients of dubious benefit. yes that was a long sentence. N'joy Also I learned that early tracheostomy does NOT decrease VAP. Had to correct an ID colleague.