Analgosedation Practices and the Impact of Sedation Depth on Clinical Outcomes Among Patients Requiring Mechanical Ventilation in the ED: A Cohort Study

Chest

Volumn 152, Issue 5, 2017, Pages 963-971

  Stephens, Robert J ^a   Ablordeppey, Enyo ^a   Drewry, Anne M ^a   Palmer, Christopher ^a   Wessman, Brian T ^a   Mohr, Nicholas M ^b   Roberts, Brian W ^c   Liang, Stephen Y ^a   Kollef, Marin H ^a   Fuller, Brian M ^a  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF IOWA   (United States)

^c Department of Anesthesiology   (United States)

Author keywords

ED; mechanical ventilation; sedation depth

Indexed keywords

DEXMEDETOMIDINE; DIAZEPAM; ETOMIDATE; FENTANYL; HALOPERIDOL; HYDROMORPHONE; KETAMINE; LORAZEPAM; MIDAZOLAM; MORPHINE; PROPOFOL; QUETIAPINE; ROCURONIUM; INTRAVENOUS ANESTHETIC AGENT; NARCOTIC ANALGESIC AGENT;

ADULT; ANALGESIA; ANESTHESIA LEVEL; ARTICLE; ARTIFICIAL VENTILATION; CLINICAL OUTCOME; CLINICAL PRACTICE; COHORT ANALYSIS; CONTROLLED STUDY; EMERGENCY WARD; FEMALE; HOSPITAL MORTALITY; HOSPITALIZATION; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MULTIVARIATE LOGISTIC REGRESSION ANALYSIS; OBSERVATIONAL STUDY; PRIORITY JOURNAL; RETROSPECTIVE STUDY; RICHMOND AGITATION SEDATION SCALE; SEDATION; TREATMENT DURATION; UNIVERSITY HOSPITAL; DEEP SEDATION; FOLLOW UP; MIDDLE AGED; PROCEDURES; PROSPECTIVE STUDY;

ANALGESICS, OPIOID; ANESTHETICS, INTRAVENOUS; DEEP SEDATION; FEMALE; FENTANYL; FOLLOW-UP STUDIES; HOSPITAL MORTALITY; HUMANS; INTENSIVE CARE UNITS; MALE; MIDAZOLAM; MIDDLE AGED; PAIN MANAGEMENT; PROSPECTIVE STUDIES; RESPIRATION, ARTIFICIAL;

EID: 85033567433     PISSN: 00123692     EISSN: 19313543     Source Type: Journal    
DOI: 10.1016/j.chest.2017.05.041     Document Type: Article

References (21)

1. Barr, J., Fraser, G.L., Puntillo, K., et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 41:1 (2013), 263–306.
2. Jackson, D.L., Proudfoot, C.W., Cann, K.F., Walsh, T., A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety. Crit Care, 14(2), 2010, 1.
3. Bhat, R., Goyal, M., Graf, S., et al. Impact of post-intubation interventions on mortality in patients boarding in the emergency department. West J Emerg Med, 15(6), 2014, 708.
4. Bonomo, J.B., Butler, A.S., Lindsell, C.J., Venkat, A., Inadequate provision of postintubation anxiolysis and analgesia in the ED. Am J. Emerg Med 26:4 (2008), 469–472.
5. Chong, I.D., Sandefur, B.J., Rimmelin, D.E., et al. Long-acting neuromuscular paralysis without concurrent sedation in emergency care. Am J Emerg Med 32:5 (2014), 452–456.
6. Weingart, G.S., Carlson, J.N., Callaway, C.W., Frank, R., Wang, H.E., Estimates of sedation in patients undergoing endotracheal intubation in US EDs. Am J Emerg Med 31:1 (2013), 222–226.
7. Shehabi, Y., Bellomo, R., Reade, M.C., et al. Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med 186:8 (2012), 724–731.
8. Tanaka, L.M.S., Azevedo, L.C.P., Park, M., et al. Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study. Crit Care, 18(4), 2014, 1.
9. Fuller BM, Ferguson IT, Mohr NM, et al. Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): a quasi-experimental, before-after trial [published online ahead of print March 1, 2017]. Ann Emerg Med. http://dx.doi.org/10.1016/j.annemergmed.2017.01.013.
10. Fuller, B.M., Ferguson, I., Mohr, N.M., et al. Lung-protective ventilation initiated in the emergency department (LOV-ED): a study protocol for a quasi-experimental, before-after trial aimed at reducing pulmonary complications. BMJ Open, 6(4), 2016, e010991.
11. Vincent, J., Moreno, R., Takala, J., et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 22:7 (1996), 707–710.
12. Vincent, J., De Mendonça, A., Cantraine, F., et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Crit Care Med 26:11 (1998), 1793–1800.
13. Vincent, J., Angus, D., Artigas, A., et al. Effects of drotrecogin alfa (activated) on organ dysfunction in the PROWESS trial. Crit Care Med 31:3 (2003), 834–840.
14. Esteban, A., Anzueto, A., Frutos, F., et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287:3 (2002), 345–355.
15. Fuller, B.M., Mohr, N.M., Dettmer, M., et al. Mechanical ventilation and acute lung injury in emergency department patients with severe sepsis and septic shock: an observational study. Acad Emerg Med 20:7 (2013), 659–669.
16. Payen, J.-F., Chanques, G., Mantz, J., et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology 106:4 (2007), 687–695.
17. Pandharipande, P.P., Pun, B.T., Herr, D.L., et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA 298:22 (2007), 2644–2653.
18. Riker, R., Shehabi, Y., Bokesch, P., SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 3015 (2009), 489–499.
19. Jakob, S.M., Ruokonen, E., Grounds, R.M., et al., Dexmedetomidine for Long-Term Sedation Investigators. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation. JAMA 307:11 (2012), 1151–1160.
20. Centre AaNZICR. Early goal-directed sedation compared with standard care in mechanically ventilated critically ill patients: a prospective multicentre randomised controlled trial. 2017. https://clinicaltrials.gov/ct2/show/NCT01728558. Accessed January 17, 2017.
21. Jackson, D.L., Proudfoot, C.W., Cann, K.F., Walsh, T.S., The incidence of sub-optimal sedation in the ICU: a systematic review. Crit Care, 13(6), 2009, 1.