Sedation practices and clinical outcomes in mechanically ventilated patients in a prospective multicenter cohort.

ABSTRACT:

Objectives

We sought to study the association between sedation status, medications (benzodiazepines, opioids, and antipsychotics), and clinical outcomes in a resource-limited setting.

Design

A longitudinal study of critically ill participants on mechanical ventilation.

Setting

Five intensive care units (ICUs) in four public hospitals in Lima, Peru.

Patients

One thousand six hundred fifty-seven critically ill participants were assessed daily for sedation status during 28?days and vital status by day 90.

Results

After excluding data of participants without a Richmond Agitation Sedation Scale score and without sedation, we followed 1338 (81%) participants longitudinally for 18,645 ICU days. Deep sedation was present in 98% of participants at some point of the study and in 12,942 ICU days. Deep sedation was associated with higher mortality (interquartile odds ratio (OR)?=?5.42, 4.23-6.95; p?ConclusionsDeep sedation, agitation, and cumulative dose of benzodiazepines were all independently associated with higher 90-day mortality. Additionally, deep sedation was associated with less ventilator-, ICU-, and hospital-free days. In contrast, haloperidol was associated with lower mortality in our study.

SUBMITTER: Aragon RE 

PROVIDER: S-EPMC6472077 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature