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Clinical Investigations In Critical CareThe Use of Continuous IV Sedation Is Associated With Prolongation of Mechanical Ventilation
Section snippets
Study Location and Patients
The study was conducted at a university-affiliated urban teaching hospital: Barnes-Jewish Hospital (1,400 beds). During a 5-month period (August 1997 to December 1997), all patients receiving mechanical ventilation in the medical ICU (19 beds) were potentially eligible for this investigation. Patients were entered into the investigation if they were >17 years and excluded if they were temporarily admitted (ie, <24 h) to the medical ICU from a surgical service while awaiting a surgical ICU bed.
Patients
A total of 242 consecutive patients requiring mechanical ventilation were evaluated. The mean age of the patients was 56.3± 17.5 years (range, 18 to 105 years). The mean APACHE II score was 20.8±8.1 (range, 1 to 59). One hundred twenty-one (50%) patients were men and 121 (50.0%) were women. The indications for mechanical ventilation included respiratory failure due to pneumonia (20.2%), drug overdose (8.3%), ARDS or ALI associated with sepsis or aspiration (13.6%), COPD or asthma (22.7%),
Discussion
We demonstrated a statistically significant association between the use of continuous IV sedation and the duration of mechanical ventilation. Even after adjusting for potential confounding variables, multiple linear regression analysis demonstrated that patients receiving continuous IV sedation had nearly twice the duration of mechanical ventilation compared with patients not receiving continuous IV sedation. Similarly, the adjusted ICU and hospital lengths of stay were statistically greater
Acknowledgments
The authors would like to thank Suzanne Ward, RN, for her assistance in formulating the study database.
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The work was supported by a grant from the Barnes-Jewish Christian Innovation in Health Care Program.