An evaluation of patient-specific characteristics on attainment of target sedation in an intensive care unit

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Abstract

Background:

Sedation of mechanically ventilated patients should optimize comfort and safety while avoiding over-sedation and adverse outcomes. To our knowledge, characteristics associated with attaining target sedation are unknown.

Objectives:

Evaluate current sedation practice at a single center and explore which patient characteristics are associated with attaining target sedation.

Methods:

This is a single-center, retrospective chart review of sedated, ventilated patients in a medical/surgical ICU. Demographic and clinical data were collected. Univariate and multivariate logistic regression analyses were used with attaining target sedation as the dependent variable.

Results:

Of the 100 patients included (median 60.5 years), 50 attained target sedation. Univariate analyses (a = 0.10) revealed factors associated with target sedation were age (P = 0.08), history of alcohol abuse (P = 0.08), multiple comorbidities (P = 0.09), and delirium monitoring (P = 0.002). Multivariate analysis revealed an association between delirium monitoring/documentation and attaining target sedation (P = 0.005; OR 9.2; 95% CI 2.3–36.8).

Conclusions:

Patients without appropriate delirium monitoring/documentation had significantly reduced likelihood of achieving target sedation.

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