機械呼吸器を投与する重症患者の鎮静剤を投与しないプロトコル:ランダム化試験
Thomas Strøm1, Torben Martinussen, Palle Toft
1Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, University of Southern Denmark, Denmark. t.s@dadlnet.dk
Lancet (London, England)
|February 2, 2010
まとめ
機械呼吸器を施している重症患者の鎮静剤なしは,呼吸補助器なしの日を大幅に増加させます. このアプローチは,中断された鎮静薬と比較して,集中治療室と病院での滞在を減少させました.
科学分野:
- クリティカルケア・メディシン
- 呼吸器療法による呼吸療法です.
- 薬理学 薬理学とは
背景:
- 継続的な鎮静剤は,機械呼吸器を使用している患者にとって標準です.
- 毎日鎮静剤を中断すると,利点があることが示されています.
- 1つのICUで鎮静剤を投与しないプロトコルが実施されました.
研究 の 目的:
- 鎮静剤を投与しないプロトコルと,毎日鎮静剤を中断するプロトコルの有効性を比較する.
- 鎮静剤の欠如が機械的換気期間を短縮するかどうかを判断する.
主な方法:
- 機械呼吸器を施している重症成人患者140人をランダムに (1:1) 鎮静剤なしまたは毎日中断された鎮静剤に分けました.
- 主要アウトカム: 28日間で機械的換気のない日.
- 副次的アウトカム:ICUと入院期間.
主要な成果:
- 鎮静剤を投与したグループには,機械呼吸器なしで過ごす日数が有意に多くなかった (13.8 vs 9.6 日).
- 鎮静剤の投与は,ICUと入院期間が短くなったことと関連づけられませんでした.
- 興奮性妄想は,鎮静剤を投与しなかったグループでより頻繁に見られた.
結論:
- 機械呼吸器を施している重症患者の鎮静剤を施さない. 呼吸器を施さない日数が増加する.
- これらの発見を検証するために,さらなる多センター研究が必要である.
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