Impact of harmful use of alcohol on the sedation of critical patients on mechanical ventilation: A multicentre prospective, observational study in 8 Spanish intensive care units
| Autor: | T. Muñoz, M.Á. Alonso, C. Pardo, H Torrado, M.J. Jiménez, Alberto Sandiumenge, C. Chamorro, J. Alonso |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Alcohol Drinking Substance-Related Disorders medicine.drug_class Sedation medicine.medical_treatment Critical Care and Intensive Care Medicine Sedoanalgesia 03 medical and health sciences 0302 clinical medicine Intensive care medicine Humans Hypnotics and Sedatives Drug Interactions Prospective Studies Treatment Failure 030212 general & internal medicine Prospective cohort study Harmful use APACHE Aged Mechanical ventilation Psychotropic Drugs Ethanol Illicit Drugs business.industry Smoking 030208 emergency & critical care medicine Middle Aged Respiration Artificial Substance Withdrawal Syndrome Intensive Care Units Spain Sedative Anesthesia Emergency medicine Female Observational study medicine.symptom business |
| Zdroj: | Medicina Intensiva (English Edition). 40:230-237 |
| ISSN: | 2173-5727 |
| DOI: | 10.1016/j.medine.2016.04.003 |
| Popis: | To evaluate the impact of a history of harmful use of alcohol (HUA) on sedoanalgesia practices and outcomes in patients on mechanical ventilation (MV).A prospective, observational multicentre study was made of all adults consecutively admitted during 30 days to 8 Spanish ICUs. Patients on MV24h were followed-up on until discharge from the ICU or death. Data on HUA, smoking, the use of illegal (IP) and medically prescribed psychotropics (MPP), sedoanalgesia practices and their related complications (sedative failure [SF] and sedative withdrawal [SW]), as well as outcome, were prospectively recorded.A total of 23.4% (119/509) of the admitted patients received MV24h; 68.9% were males; age 57.0 (17.9) years; APACHE II score 18.8 (7.2); with a medical cause of admission in 53.9%. Half of them consumed at least one psychotropic agent (smoking 27.7%, HUA 25.2%; MPP 9.2%; and IP 7.6%). HUA patients more frequently required PS (86.7% vs. 64%; p0.02) and the use of2 sedatives (56.7% vs. 28.1%; p0.02). HUA was associated to an eightfold (p0.001) and fourfold (p0.02) increase in SF and SW, respectively. In turn, the duration of MV and the stay in the ICU was increased by 151h (p0.02) and 4.4 days (p0.02), respectively, when compared with the non-HUA group. No differences were found in terms of mortality.HUA may be associated to a higher risk of SF and WS, and can prolong MV and the duration of stay in the ICU in critical patients. Early identification could allow the implementation of specific sedation strategies aimed at preventing these complications. |
| Databáze: | OpenAIRE |
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