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Abstract: Objective To evaluate the efficacy and safety of different degree of sedation in the treatment of patients with mechanical ventilation. Methods 405 patients who received mechanical ventilation over 48 hour from January 2014 to December 2016 in ICU of the hospital were enrolled. According to different methods of sedation, the patients were divided into intermittent sedation group (192 patients) and continuous sedation group (213 patients). The patients with continuous sedation were divided into light sedation group (SAS score 23) and deep sedation group (SAS score 45) according to the SAS scores. Each group was given fentanyl for analgesia and propofol or midazolam for sedation. Duration of mechanical ventilation, ICU hospitalization time, total hospitalization time, hospitalization fatality rate and incidence of complications and adverse events were recorded.Results Compared with the continuous sedation group,the duration of mechanical ventilation were significantly shorter than the intermittent sedation group(P<0.05). ICU hospitalization time, total hospitalization time, hospitalization fatality rate showed no significant differences between two groups(P>0.05). In the continuous sedation group, with continuous light sedation group compared to continuous deep sedation group, mechanical ventilation time, ICU hospitalization time and total hospitalization time were significantly longer and the incidence of VAP was significantly higher in continuous deep sedation group (all P<0.05).Compared with the last light sedation group for deep sedation group,the mechanical ventilation time and ICU length of hospital stay, the total length of hospital stay and the incidence of VAP were significantly longer in the continuous light sedation group (all P<0.05).Hospital mortality, the incidence of delirium and accidental extubation of two groups had no statistical significance (P>0.05). Conclusion Intermittent sedation and continuous sedation were feasible during mechanical ventilation, but the incidence of VAP was significantly reduced by continued shallow sedation, shortened mechanical ventilation and ICU hospitalization time.
Key words: respiration, artificial; , conscious sedation;deep , sedation;intensive care units
Bu Ke, Liu Lingang, Zhang Raorao. Retrospectively analysis of different degree of sedation in patients with mechanical ventilation in adult ICU[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2017.09.011.
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2017.09.011
https://huicui.hebmu.edu.cn/EN/Y2017/V32/I9/778