Preventive effect of early comfort using analgesia, minimal sedatives and maximal humane care concept on delirium in patients in coronary care unit

Objective To observe the preventive effect of early comfort using analgesia, minimal sedatives and maximal humane care (eCASH)concept on delirium in patients in coronary care unit(CCU).

Methods The clinical data of 136 CCU patients admitted from June 2021 to January 2023 were retrospectively analyzed. Patients received routine delirium prevention care from June 2021 to March 2022 were included in control group (n=69), and patients received eCASH philosophy care from April 2022 to January 2023 were included in observation group (n=67). Delirium prevention effect, condition of restlessness and sedation, CCU length of stay and cognitive function were compared between the two groups.

Results The incidence of delirium in the observation group was 4.48%, which was significantly lower than 17.39% in the control group (P < 0.05). The duration of delirium and CCU length of stay in the observation group were significantly shorter than those in the control group (P < 0.05). After intervention, the scores of Richmond Agitation and Sedation Scale (RASS) and Montreal Cognitive Assessment Scale (MoCA) were significantly higher in the two groups than before intervention, and the observation group was significantly higher than the control group (P < 0.05). The average dose of analgesic and sedative drugs (propofol and regal) in the observation group was significantly lower than that in the control group (P < 0.05).

Conclusion The analgesic and sedative control scheme based on eCASH concept can reduce the incidence of delirium, shorten the duration of delirium and hospital stay, and improve the agitation sedation and cognitive function of CCU patients.