International Analgesia, Sedation, and Delirium Practices: a prospective cohort study.
Agitation
Analgesia
Critical illness
Delirium
Mechanical ventilation
Journal
Journal of intensive care
ISSN: 2052-0492
Titre abrégé: J Intensive Care
Pays: England
ID NLM: 101627304
Informations de publication
Date de publication:
2019
2019
Historique:
received:
04
03
2019
accepted:
04
04
2019
entrez:
4
5
2019
pubmed:
3
5
2019
medline:
3
5
2019
Statut:
epublish
Résumé
While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions. We performed a retrospective analysis of two multicenter, international, prospective cohort studies. Mechanically ventilated adults were followed for up to 28 days in 2010 and 2016. Proportion of days utilizing sedation, analgesia, and performance of a spontaneous awakening trial (SAT), and occurrence of delirium were described for each year and region and compared between years. A total of 14,281 patients from 6 international regions were analyzed. Proportion of days utilizing analgesia and sedation increased from 2010 to 2016 ( Analgesia and sedation practices varied widely across international regions and significantly changed over time. Opportunities for improvement in care include increasing delirium monitoring, performing SATs, and decreasing use of sedation, particularly benzodiazepines.
Sections du résumé
BACKGROUND
BACKGROUND
While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions.
METHODS
METHODS
We performed a retrospective analysis of two multicenter, international, prospective cohort studies. Mechanically ventilated adults were followed for up to 28 days in 2010 and 2016. Proportion of days utilizing sedation, analgesia, and performance of a spontaneous awakening trial (SAT), and occurrence of delirium were described for each year and region and compared between years.
RESULTS
RESULTS
A total of 14,281 patients from 6 international regions were analyzed. Proportion of days utilizing analgesia and sedation increased from 2010 to 2016 (
CONCLUSIONS
CONCLUSIONS
Analgesia and sedation practices varied widely across international regions and significantly changed over time. Opportunities for improvement in care include increasing delirium monitoring, performing SATs, and decreasing use of sedation, particularly benzodiazepines.
Identifiants
pubmed: 31049203
doi: 10.1186/s40560-019-0379-z
pii: 379
pmc: PMC6480848
doi:
Types de publication
Journal Article
Langues
eng
Pagination
25Déclaration de conflit d'intérêts
The study was approved by IRBs at individual ISMV study sites and Vanderbilt University Medical Center.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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