Influence of early goal-directed sedation strategy on incidence of delirium and sedation effect in critically ill patients with mechanical ventilation

JU Mi; CHEN Zhilin; WANG Yang; HE Zhiwei

doi:10.7619/jcmp.20221326

Journal of Clinical Medicine in Practice > 2022 > 26(20): 45-47, 52. > DOI: 10.7619/jcmp.20221326

JU Mi, CHEN Zhilin, WANG Yang, HE Zhiwei. Influence of early goal-directed sedation strategy on incidence of delirium and sedation effect in critically ill patients with mechanical ventilation[J]. Journal of Clinical Medicine in Practice, 2022, 26(20): 45-47, 52. DOI: 10.7619/jcmp.20221326

Citation:

PDF (668 KB)

Influence of early goal-directed sedation strategy on incidence of delirium and sedation effect in critically ill patients with mechanical ventilation

1.
Intensive Care Unit, Hainan Cancer Hospital, Haikou, Hainan, 570312
2.
Intensive Care Unit, the First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570102

More Information

Received Date: April 22, 2022
Available Online: November 03, 2022

Graphical Abstract

Abstract

Abstract

Objective
To investigate the influence of early goal-directed sedation strategy (EGDS) on the incidence of delirium and sedation effect in critically ill patients with mechanical ventilation.
Methods
A total of 200 hospitalized patients in the Intensive Care Unit (ICU) from July 2019 to July 2021 were selected as research objects, and they were randomly divided into observation group and control group, with 100 cases in each group. The control group was conducted with standardized sedation strategy, and the observation group was conducted with EGDS strategy. After intervention, the ratio of superficial sedation, incidence of delirium, mechanical ventilation time, hospital stay and the total dose per capita of midazolam were compared between the two groups.
Results
After intervention, the rate of superficial sedation in the observation group was 56.00%, which was significantly higher than 37.00% in the control group (P < 0.05). The mechanical ventilation time, hospital stay and incidence of delirium in the observation group were (7.68±3.31) h, (10.17±3.88) d and 14.00% respectively, which were significantly shorter or lower than (11.72±3.63) h, (19.21±4.05) d and 35.00% in the control group (P < 0.05). The total dose per capita of midazolam in the observation group was (2.55±1.46) mg, which was significantly lower than (8.27±2.05) mg in the control group (P < 0.05).
Conclusion
EGDS can maintain the status of superficial sedation in patients, reduce the dosage of sedatives and the incidence of delirium, and shorten the mechanical ventilation time and hospital stay.
- early goal-directed sedation strategy,
- mechanical ventilation,
- delirium,
- sedation,
- ventilation time

FullText(HTML)

References (18)

References

[1]	WONG I M J, THANGAVELAUTHAM S, LOH S C H, et al. Sedation and delirium in the intensive care unit-A practice-based approach[J]. Ann Acad Med Singap, 2020, 49(4): 215-225. doi: 10.47102/annals-acadmed.sg.202013
[2]	DE WET C J, MCCONNELL K, JACOBSOHN E. Progress in postoperative ICU management[J]. Thorac Surg Clin, 2005, 15(1): 159-180. doi: 10.1016/j.thorsurg.2004.09.001
[3]	PARK H Y, KIM M J, KIM J Y, et al. Could peer support programs be a good resource for managing the unmet needs of cancer patients[J]. J Cancer Educ, 2019, 34(5): 950-957. doi: 10.1007/s13187-018-1399-4
[4]	申文娟, 易兴科, 张凯, 等. 早期目标导向镇静用于慢性阻塞性肺疾病急性加重机械通气患者的临床观察[J]. 临床肺科杂志, 2020, 25(4): 520-524. doi: 10.3969/j.issn.1009-6663.2020.04.008
[5]	杨贵荣, 郭晓东, 毛更生, 等. 早期目标导向镇静在急性脑损伤中的应用[J]. 中华危重病急救医学, 2020, 32(3): 345-349. doi: 10.3760/cma.j.cn121430-20200106-00092
[6]	MIRABELLA L, CINNELLA G, COSTA R, et al. Patient-ventilator asynchronies: clinical implications and practical solutions[J]. Respir Care, 2020, 65(11): 1751-1766. doi: 10.4187/respcare.07284
[7]	VOLPE M S, GUIMARÃES F S, MORAIS C C. Airway clearance techniques for mechanically ventilated patients: insights for optimization[J]. Respir Care, 2020, 65(8): 1174-1188. doi: 10.4187/respcare.07904
[8]	DEXTER A M, CLARK K. Ventilator graphics: scalars, loops, & secondary measures[J]. Respir Care, 2020, 65(6): 739-759. doi: 10.4187/respcare.07805
[9]	NAUE W D S, HERVE B B, VIEIRA F N, et al. Reply to: comparison of bronchial hygiene techniques in mechanically ventilated patients: a randomized clinical trial[J]. Rev Bras Ter Intensiva, 2019, 31(4): 596-597.
[10]	GROTBERG J C, HYZY R C, DE CARDENAS J, et al. Bronchopleural fistula in the mechanically ventilated patient: a concise review[J]. Crit Care Med, 2021, 49(2): 292-301. doi: 10.1097/CCM.0000000000004771
[11]	WELLGE B E, TREPTE C J, ZÖLLNER C, et al. Perioperatives VolumenmanagementPerioperative fluid management[J]. Chirurg, 2020, 91(2): 121-127. doi: 10.1007/s00104-020-01134-6
[12]	LOBDELL K W, CHATTERJEE S, SANDER M. Goal-directed therapy for cardiac surgery[J]. Crit Care Clin, 2020, 36(4): 653-662. doi: 10.1016/j.ccc.2020.06.004
[13]	LU Y, ZHANG H, TENG F, et al. Early goal-directed therapy in severe Sepsis and septic shock: a meta-analysis and trial sequential analysis of randomized controlled trials[J]. J Intensive Care Med, 2018, 33(5): 296-309. doi: 10.1177/0885066616671710
[14]	蔺珊. 持续浅镇静目标导向联合音乐疗法在ICU重症颅脑损伤机械通气患者中的应用效果[J]. 护理实践与研究, 2021, 18(9): 1351-1354. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202109023.htm
[15]	卞红, 俞萍. 早期目标导向活动方案对ICU机械通气病人获得性衰弱的影响[J]. 护理研究, 2021, 35(7): 1248-1251. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202107027.htm
[16]	杨贵荣, 杨长春, 毛更生, 等. 早期目标导向镇静对急性脑损伤患者脑氧代谢的影响[J]. 中华危重病急救医学, 2021, 33(1): 79-83.
[17]	张帅, 陈娟红, 富燕萍, 等. 早期目标导向活动在心脏术后患者康复中的应用效果[J]. 中华现代护理杂志, 2020, 26(33): 4640-4644. doi: 10.3760/cma.j.cn115682-20200312-01675
[18]	吴钿生, 周洪彬, 黄焕森. 目标导向液体治疗对肾移植术后早期功能恢复及并发症的影响[J]. 临床麻醉学杂志, 2020, 36(10): 980-983. doi: 10.12089/jca.2020.10.010

[1]	YANG Junxia. Effect of rehabilitation nursing intervention on the improvement of quality of life in patients with cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2019, 23(12): 96-98, 102. DOI: 10.7619/jcmp.201912028
[2]	JIANG Rongfei, XU Ling, LI Xiaohua. Influence of pulmonary rehabilitation training combined with seretide and tiotropium bromide on pulmonary function, exercise endurance and quality of life in patients with moderate and severe COPD[J]. Journal of Clinical Medicine in Practice, 2017, (9): 28-30,34. DOI: 10.7619/jcmp.201709007
[3]	CHENG Hong, TANG Yong, HU Bin. Effect of high quality nursing on quality of life in elderly patients with chronic bronchitis[J]. Journal of Clinical Medicine in Practice, 2016, (8): 37-39. DOI: 10.7619/jcmp.201608012
[4]	Influence of counterpart nursing on the pain and life quality of patients with gout[J]. Journal of Clinical Medicine in Practice, 2016, (6): 35-38. DOI: 10.7619/jcmp.201606012
[5]	FAN Wenxia, XIAO Qiong, ZHOU Ke. Clinical observation on the effect of nursing intervention on psychologyand quality of life in patients with hemodialysis[J]. Journal of Clinical Medicine in Practice, 2015, (14): 36-38. DOI: 10.7619/jcmp.201514012
[6]	YANG Xiaoping, CHEN Qinjie, LI Lina, CHEN Qing. Quality of life in infertile couples and its influencing factors[J]. Journal of Clinical Medicine in Practice, 2015, (10): 71-74. DOI: 10.7619/jcmp.201510022
[7]	XIANG Mei, LIU Aihua. The impact of high quality nursing on adverse emotion and quality of life in patients with colorectal cancer after operation[J]. Journal of Clinical Medicine in Practice, 2015, (6): 62-64. DOI: 10.7619/jcmp.201506020
[8]	WANG Mei, LIU Falan. The influence of self-management guidance on the hope level and life quality in COPD patients[J]. Journal of Clinical Medicine in Practice, 2014, (12): 112-114. DOI: 10.7619/jcmp.201412038
[9]	DING Jiehong. The effect of evidence-based nursing on life quality of gastric ulcer patients[J]. Journal of Clinical Medicine in Practice, 2014, (10): 89-90,93. DOI: 10.7619/jcmp.201410031
[10]	SONG Wenying. Influence of nursing intervention on the quality of life of patients with depression[J]. Journal of Clinical Medicine in Practice, 2013, (16): 147-149. DOI: 10.7619/jcmp.201316057

Cited By

Cited by

Periodical cited type(7)

1.	付政平，董贤明，秦建领，卢奎彬，渠展，王庆丰，汤聪，徐红艳，岳雨倩. 社区获得性肺炎凝血功能异常对治疗和预后的影响. 山西卫生健康职业学院学报. 2024(06): 40-42 .
2.	叶文，龙尧水，陈咏梅，胡泽玉，白文学. MPV、PCT、PDW、P-LCR、MPR对儿童SCAP的诊断价值. 检验医学与临床. 2023(09): 1325-1329 .
3.	吴颖，高蔚，翁婷. 血浆FIB-PLT-DD联合检测在慢性肺源性心脏病治疗中的临床意义. 中国医药科学. 2023(19): 177-180+185 .
4.	史妹，周历安，符叶柳. 床旁肺超声B线计数及外周血嗜酸性粒细胞评估慢性阻塞性肺疾病并发肺炎的价值及其相关因素分析. 海军医学杂志. 2023(12): 1243-1247 .
5.	雷云飞，宋影，王亚冰. D–二聚体及凝血功能指标对慢性阻塞性肺疾病的检验价值. 深圳中西医结合杂志. 2022(23): 54-56 .
6.	黄鑫，王卫阳. 阿莫西林克拉维酸钾联合补肺活血胶囊对慢性阻塞性肺疾病患者肺功能及预后影响. 临床军医杂志. 2021(07): 785-786 .
7.	李刚，孙雨婷，王佳美，李满元. 外周血平均血小板体积在儿童社区获得性肺炎中的价值. 中国医药指南. 2021(31): 87-88+91 .

Other cited types(0)

Get Citation

PDF

XML

Article views (145) PDF downloads (4) Cited by(7)

Turn off MathJax

Article Contents

Abstract

References

Influence of early goal-directed sedation strategy on incidence of delirium and sedation effect in critically ill patients with mechanical ventilation

Abstract

References

Related Articles

Cited by

Periodical cited type(7)

Other cited types(0)

Catalog

Influence of early goal-directed sedation strategy on incidence of delirium and sedation effect in critically ill patients with mechanical ventilation

Abstract

References

Related Articles

Cited by

Periodical cited type(7)

Other cited types(0)

Catalog

Export File

Citation

Format

Content