Effects of sedatives and opioids on trigger and cycling asynchronies throughout mechanical ventilation: an observational study in a large dataset from critically ill patients
| العنوان: | Effects of sedatives and opioids on trigger and cycling asynchronies throughout mechanical ventilation: an observational study in a large dataset from critically ill patients |
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| المؤلفون: | Montserrat Rué, Lluis Blanch, Umberto Lucangelo, A. Ochagavía, Rafael Fernandez, Yoanna Skrobik, Carles Subirà, Rudys Magrans, Robert M. Kacmarek, Candelaria de Haro, Jaume Montanya, Guillermo M. Albaiceta, Sol Fernandez-Gonzalo, Enrico Lena, Gemma Gomà, Josefina López-Aguilar, Gastón Murias |
| المساهمون: | de Haro, Candelaria, Magrans, Rudy, López-Aguilar, Josefina, Montanyà, Jaume, Lena, Enrico, Subirà, Carle, Fernandez-Gonzalo, Sol, Gomà, Gemma, Fernández, Rafael, Albaiceta, Guillermo M., Skrobik, Yoanna, Lucangelo, Umberto, Murias, Gastón, Ochagavia, Ana, Kacmarek, Robert M., Rue, Montserrat, Blanch, Lluís |
| المصدر: | Scopus Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Recercat: Dipósit de la Recerca de Catalunya Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) Recercat. Dipósit de la Recerca de Catalunya instname Repositorio Abierto de la UdL Universitad de Lleida Critical Care, Vol 23, Iss 1, Pp 1-11 (2019) Critical Care RUO. Repositorio Institucional de la Universidad de Oviedo |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Ineffective inspiratory efforts during expiration, medicine.medical_treatment, Asynchronies, Medications, Critical Care and Intensive Care Medicine, Respiració artificial, 0302 clinical medicine, Mechanical ventilation, Pacientes hospitalizados, Hypnotics and Sedatives, Sedatives, Opioids, Double cycling, Prospective Studies, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, Hospitalized patients, Analgesics, Opioid, Intensive Care Units, Anesthesia, Breathing, Medicamentos, Female, medicine.symptom, Medicaments, medicine.drug, medicine.drug_class, Critical Illness, Sedation, Opioid, Pacients hospitalitzats, Opiáceos, 03 medical and health sciences, medicine, Humans, Opiacis, Dosing, Aged, Asynchronie, Critically ill, business.industry, Research, Sedative, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Respiration, Artificial, Spain, Respiratory Mechanics, Observational study, business, Respiración artificial |
| الوصف: | BACKGROUND: In critically ill patients, poor patient-ventilator interaction may worsen outcomes. Although sedatives are often administered to improve comfort and facilitate ventilation, they can be deleterious. Whether opioids improve asynchronies with fewer negative effects is unknown. We hypothesized that opioids alone would improve asynchronies and result in more wakeful patients than sedatives alone or sedatives-plus-opioids. METHODS: This prospective multicenter observational trial enrolled critically ill adults mechanically ventilated (MV) > 24 h. We compared asynchronies and sedation depth in patients receiving sedatives, opioids, or both. We recorded sedation level and doses of sedatives and opioids. BetterCare™ software continuously registered ineffective inspiratory efforts during expiration (IEE), double cycling (DC), and asynchrony index (AI) as well as MV modes. All variables were averaged per day. We used linear mixed-effects models to analyze the relationships between asynchronies, sedation level, and sedative and opioid doses. RESULTS: In 79 patients, 14,166,469 breaths were recorded during 579 days of MV. Overall asynchronies were not significantly different in days classified as sedatives-only, opioids-only, and sedatives-plus-opioids and were more prevalent in days classified as no-drugs than in those classified as sedatives-plus-opioids, irrespective of the ventilatory mode. Sedative doses were associated with sedation level and with reduced DC (p |
| وصف الملف: | application/pdf; ELETTRONICO |
| اللغة: | English |
| تدمد: | 0345-1461 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7b05c49f2620e90321965b4229701dd2Test http://hdl.handle.net/10651/53028Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7b05c49f2620e90321965b4229701dd2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 03451461 |
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