连续镇静剂的比较在烧伤ICU在妄和昏迷的持续镇静剂
Jessica A Falksen1, Sierra R Young1, Jin A Lee1
1Department of Pharmacy Services, University of California Davis Health, 2315 Stockton Blvd, Sacramento, CA 95817, USA.
概括
疼痛镇静是一种较轻的镇静策略,与深度镇静相比,在重症烧伤患者中显著增加了无昏迷和妄想的日子. 这种方法可能会改善这个弱势群体的结果.
科学领域:
- 临界护理医学 临界护理医学
- 烧伤伤害管理管理
- 镇静药理学 镇静药理学
背景情况:
- 较轻的镇静策略改善了一般重症监护室 (ICU) 患者的治疗结果.
- 现有的镇静指南往往没有专门解决烧伤患者的独特需求.
- 初始镇静深度对烧伤患者恢复标志物的影响需要进一步调查.
研究的目的:
- 评估初始连续镇静剂选择对危重病成人烧伤患者昏迷和妄无天的影响.
- 在这个特定的患者群体中,比较深度镇静,轻度镇静和疼痛镇静之间的结果.
主要方法:
- 在2010年至2019年期间接受烧伤重症监护室的107名成年烧伤患者的回顾性队列研究.
- 根据最初的连续镇静,患者被分为三组:深度,轻度或疼痛镇静.
- 包括标准包括输管和连续镇静剂输注至少48小时.
主要成果:
- 在镇静组中观察到无昏迷和狂妄症日的显著差异 (P = 0.024).
- 疼痛镇静产生了最多的无昏迷和妄想日 (8天),而深度镇静产生了最少的 (3天).
- 没有昏迷的日子显示出显著的差异 (P = 0.00008); 观察到深度镇静的死亡率较高的趋势,尽管在统计学上并不显著.
结论:
- 最初的疼痛静坐与严重病情的烧伤患者昏迷和妄想无症状日数显著增加有关.
- 这些发现表明,较轻的镇静策略,特别是疼痛镇静,可能有利于烧伤重症监护室的康复.
- 需要进一步的研究来证实对死亡率的影响,并优化烧伤人群的镇静方案.
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