The implementation of an analgesia-based sedation protocol reduced deep sedation and proved to be safe and feasible in patients on mechanical ventilation

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dc.contributor.authorBugedo Tarraza, Guillermo
dc.contributor.authorTobar, E.
dc.contributor.authorAguirre, M.
dc.contributor.authorGonzalez, H.
dc.contributor.authorGodoy, J.
dc.contributor.authorLira, M. T.
dc.contributor.authorLora, P.
dc.contributor.authorEncalada, E.
dc.contributor.authorHernandez, A.
dc.contributor.authorTomicic, V.
dc.contributor.authorCastro, J.
dc.contributor.authorJara, J.
dc.contributor.authorAndresen Hernández, Max
dc.contributor.authorUgarte, H.
dc.date.accessioned2020-01-14T01:06:53Z
dc.date.available2020-01-14T01:06:53Z
dc.date.issued2013
dc.description.abstractINTRODUCTION: Deep sedation in critically ill patients is associated with a longer duration of mechanical ventilation and a prolonged length of stay in the intensive care unit. Several protocols have been used to improve these outcomes. We implement and evaluate an analgesia-based, goal-directed, nurse-driven sedation protocol used to treat critically ill patients who receive mechanical ventilation. METHODS: We performed a prospective, two-phase (before-after), non-randomized multicenter study that involved 13 intensive care units in Chile. After an observational phase (observational group, n=155), we designed, implemented and evaluated an analgesia-based, goal-directed, nurse-driven sedation protocol (intervention group, n=132) to treat patients who required mechanical ventilation for more than 48 hours. The primary outcome was to achieve ventilator-free days by day 28. RESULTS: The proportion of patients in deep sedation or in a coma decreased from 55.2% to 44.0% in the interventional group. Agitation did not change between the periods and remained approximately 7%. Ventilator-free days to day 28, length of stay in the intensive care unit and mortality were similar in both groups. At one year, post-traumatic stress disorder symptoms in survivors were similar in both groups. CONCLUSIONS: We designed and implemented an analgesia-based, goal-directed, nurse-driven sedation protocol in Chile. Although there was no improvement in major outcomes, we observed that the present protocol was safe and feasible and that it resulted in decreased periods of deep sedation without increasing agitation.INTRODUCTION: Deep sedation in critically ill patients is associated with a longer duration of mechanical ventilation and a prolonged length of stay in the intensive care unit. Several protocols have been used to improve these outcomes. We implement and evaluate an analgesia-based, goal-directed, nurse-driven sedation protocol used to treat critically ill patients who receive mechanical ventilation. METHODS: We performed a prospective, two-phase (before-after), non-randomized multicenter study that involved 13 intensive care units in Chile. After an observational phase (observational group, n=155), we designed, implemented and evaluated an analgesia-based, goal-directed, nurse-driven sedation protocol (intervention group, n=132) to treat patients who required mechanical ventilation for more than 48 hours. The primary outcome was to achieve ventilator-free days by day 28. RESULTS: The proportion of patients in deep sedation or in a coma decreased from 55.2% to 44.0% in the interventional group. Agitation did not change between the periods and remained approximately 7%. Ventilator-free days to day 28, length of stay in the intensive care unit and mortality were similar in both groups. At one year, post-traumatic stress disorder symptoms in survivors were similar in both groups. CONCLUSIONS: We designed and implemented an analgesia-based, goal-directed, nurse-driven sedation protocol in Chile. Although there was no improvement in major outcomes, we observed that the present protocol was safe and feasible and that it resulted in decreased periods of deep sedation without increasing agitation.
dc.fechaingreso.objetodigital2024-08-14
dc.fuente.origenFacultad de Medicina
dc.identifier.doi10.5935/0103-507X.20130034
dc.identifier.issn0103-507x
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/27451
dc.issue.numeroNo. 3
dc.language.isoen
dc.nota.accesoContenido completo
dc.revistaRev Bras Ter Intensivaes_ES
dc.rightsacceso abierto
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.otherEnfermos crónicoses_ES
dc.subject.otherSedanteses_ES
dc.subject.otherRespiración artificiales_ES
dc.titleThe implementation of an analgesia-based sedation protocol reduced deep sedation and proved to be safe and feasible in patients on mechanical ventilationes_ES
dc.title.alternativeImplantação de protocolo de redução de sedação profunda baseado em analgesia comprovadamente seguro e factível em pacientes submetidos à ventilação mecânica
dc.typeartículo
dc.volumenVol. 25
sipa.codpersvinculados60490
sipa.codpersvinculados99788
sipa.codpersvinculados67514
sipa.codpersvinculados101554
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