Network members

You are here

Association of early sedation level with patient outcomes in moderate-to-severe acute respiratory distress syndrome: Propensity-score matched analysis.

TitleAssociation of early sedation level with patient outcomes in moderate-to-severe acute respiratory distress syndrome: Propensity-score matched analysis.
Publication TypeJournal Article
Year of Publication2022
AuthorsPalakshappa JA, Russell GB, Gibbs KW, Kloefkorn C, Hayden D, Moss M, Hough CL, D Files C
Corporate AuthorsNHLBI PETAL Network
JournalJ Crit Care
Volume71
Pagination154118
Date Published2022 Oct
ISSN1557-8615
KeywordsHumans, Hypnotics and Sedatives, Intensive Care Units, Propensity Score, Respiration, Artificial, Respiratory Distress Syndrome
Abstract

PURPOSE: Studies of early depth of sedation in mixed critically ill populations have suggested benefit to light sedation; however, the relationship of early depth of sedation with outcomes in patients with acute respiratory distress syndrome (ARDS) is unknown.MATERIALS AND METHODS: We performed a propensity-score matched analysis of early light sedation (Richmond Agitation Sedation Scale Score, RASS 0 to -1 or equivalent) versus deep sedation (RASS -2 or lower) in patients enrolled in the non-intervention group of The Reevaluation of Systemic Early Neuromuscular Blockade trial. Primary outcome was 90 day mortality. Secondary outcomes included days free of mechanical ventilation, days not in ICU, days not in hospital at day 28.RESULTS: 137 of 486 participants (28.2%) received early light sedation. Vasopressor usage and Apache III scores significantly differed between groups. Prior to matching, 90-day mortality was higher in the early deep sedation (45.3%) compared to light sedation (34.2%) group. In the propensity score matched cohort, there was no difference in 90-day mortality (Odds Ratio (OR) 0.72, 95% CI 0.41, 1.27, p = 0.26) or secondary outcomes between the groups.CONCLUSIONS: We did not find an association between early depth of sedation and clinical outcomes in this cohort of patients with moderate-to-severe ARDS.

DOI10.1016/j.jcrc.2022.154118
Alternate JournalJ Crit Care
PubMed ID35905586
PubMed Central IDPMC9419605
Grant ListU01 HL123009 / HL / NHLBI NIH HHS / United States
U01 HL122998 / HL / NHLBI NIH HHS / United States
U01 HL123018 / HL / NHLBI NIH HHS / United States
U01 HL123023 / HL / NHLBI NIH HHS / United States
U01 HL123008 / HL / NHLBI NIH HHS / United States
U01 HL123031 / HL / NHLBI NIH HHS / United States
U01 HL123004 / HL / NHLBI NIH HHS / United States
U01 HL123027 / HL / NHLBI NIH HHS / United States
U01 HL123010 / HL / NHLBI NIH HHS / United States
U01 HL123033 / HL / NHLBI NIH HHS / United States
U01 HL122989 / HL / NHLBI NIH HHS / United States
U01 HL123022 / HL / NHLBI NIH HHS / United States
U01 HL123020 / HL / NHLBI NIH HHS / United States
K23 AG073529 / AG / NIA NIH HHS / United States
K24 HL141526 / HL / NHLBI NIH HHS / United States
K08 GM123322 / GM / NIGMS NIH HHS / United States