|
ИСТИНА |
Войти в систему Регистрация |
ИПМех РАН |
||
Impact of sedation method on mortality and clinically relevant outcomesтезисы доклада
- Авторы: Kadantseva K., Yadgarov M., Landoni G., Berikashvili L., Kuzovlev A., Likhvantsev V.
- Сборник: European Journal of Anaesthesiology
- Серия: e-Supplement 61
- Том: 40
- Тезисы
- Год издания: 2023
- Место издания: European Journal of Anaesthesiology
- Первая страница: 294
- Последняя страница: 295
- Номер статьи: 09AP05-01
- Аннотация: Background and Goal of Study: Sedation is frequently used in in-tensive care units (ICUs) to prevent arouse and delirium associatedharm, relieve anxiety, and reduce the stress of being mechanicallyventilated. Since agitation and anxiety occurs in about 30%-80%of patients being treated in the ICU settings, sedation is a highlysought strategy for ICU patients.The aim of this study was to comprehensively assess publishedrandomized and non-randomized peer-reviewed studies whichcompared volatile (VA) and intravenous (I/V) anesthetics for ICU se-dation, with the hypothesis that the type of sedation may have animpact on mortality and other clinically relevant outcomes.Materials and Methods: Studies comparing VA versus I/V anes-thetics used in the ICU settings were independently systematicallysearched in PubMed, Medline, Google Scholar, Russian ScienceCitation Index and Cochrane databases. 15 studies (1520 patientsof predominantly surgical profile needed VA sedation for less than96 h) were included Results and Discussion: VA had no impact on all-cause mortal-ity (very low quality of evidence, Odds Ratio=0.82 [0.60-1.12], p =0.20). VA were associated with a reduction in duration of mechanicalventilation (very low quality of evidence, Odds Ratio=−0.46 [−0.88to −0.04)], p = 0.03), increase in ventilator-free days (very low qual-ity of evidence, Odds Ratio=0.46 [0.28-0.64], p < 0.001). VA alsoreduced postoperative level of cardiac troponin (low quality of evi-dence, Odds Ratio=−0.52 [−0.84 to −0.20], p = 0.001), time to ex-tubation (moderate quality of evidence, Odds Ratio= −1.59 [−2.26to −0.91]; p <0.001) and awakening (very low quality of evidence,Odds Ratio=−1.30 [−2.54 to −0.06]; p = 0.04). No dif ferenceswere observed in length of ICU stay (moderate quality of evidence,p=0.93), length of hospital stay (low quality of evidence, p=0.69),and need for catecholamines (very low quality of evidence, p = 0.5).Conclusion(s): Volatile sedation vs propofol causes the increase inventilator-free days acompined with reduction of time to ex tubationand the drop of troponin release in both medical or surgical ICUpatients. The shortening of awakening was proofed only for surgicalICU patients.https://www.esaic.org/uploads/2023/06/ea23_abstract_book.pdf
- Добавил в систему: Каданцева Кристина Кирилловна