| Autor: |
Jennifer A. Cuthill, Lyndsey Jarvie, Christopher McGovern, Martin Shaw |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
EClinicalMedicine, Vol 26, Iss , Pp 100486- (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2589-5370 |
| DOI: |
10.1016/j.eclinm.2020.100486 |
| Popis: |
Background: Early deep sedation in mechanically ventilated patients during the first 48 h of intensive care unit (ICU) admission can be associated with adverse outcomes. We hypothesised that moving the ‘daily sedation break’ process forwards, might allow earlier titration of sedation to target levels – an ‘early sedation cessation’ (ESC). Methods: We commenced a quality improvement project with the primary outcome being to stop sedation completely, within 4 h of ICU admission, in 95% of eligible patients. This was done by small, step-wise tests of change. No ethical approval was required. Findings: Between 1 February 2014 and 31 January 2018, 1787 intubated patients were included. 1052 received an ‘ESC’ within 4 h (‘Yes’), 545 were excluded (‘Excluded’), and 190 were inadvertently omitted from ‘ESC’ (‘No’). The primary aim was achieved for the first time after 12 months. Compared to the ‘Yes’ group, the ‘Excluded’ group received 38% more propofol in the first 48 h of admission (IRR 1.38 (1.31–1.47), p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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