[EVALUATION OF SEDATION USING THE RICHMOND AGITATION SEDATION SCALE IN PATIENTS WITH PROLONGED MECHANICAL
Introduction:
Sedation is monitored to avoid both under- and oversedation.
Objectives:
Determine the most prevalent sedation levels in the ICU according to RASS categories and whether treatment is individualized on the basis of these scores.
Methods:
Prospective cohort study of patients connected to mechanical ventilation ≥ 96 hours in the intensive care unit between January 1 and August 31. Daily assessments were recorded in the intensive care unit, together with sedoanalgesic treatment, ventilation modes, or vital signs.
Results:
We analyzed 1021 RASS scores collected over a total of 220 MV days, categorized in the following ranges: 404 (39.6%) deep sedation, 474 (46.4%) conscious sedation, and 54 (5.3%) agitation; 89 (8.7%) were missing scores. Patients receiving continuous sedoanalgesia were more likely to be in the deep sedation than conscious sedation range (87.1% vs. 32.3%, p < 0.001). Analysis of patients under continuous sedation and in ventilation mode found more changes in the conscious sedation range than in deep sedation (42.5% vs. 22.3% and 12.6% vs. 2.9%, respectively; p < 0.001 in both cases). In conscious sedation range there was increased use of opiates in bolus (6.4%).
Conclusions:
Deep sedation was clearly prevalent in patients with mechanical ventilation under continuous sedation, with few changes in ventilation mode, because it is prevalent control ventilation mode and no changes in sedonalagesic perfusion in that range.
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