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Association of early sedation level with patient outcomes in moderate-to-severe acute respiratory distress syndrome: Propensity-score matched analysis.
Title | Association of early sedation level with patient outcomes in moderate-to-severe acute respiratory distress syndrome: Propensity-score matched analysis. |
Publication Type | Journal Article |
Year of Publication | 2022 |
Authors | Palakshappa JA, Russell GB, Gibbs KW, Kloefkorn C, Hayden D, Moss M, Hough CL, D Files C |
Corporate Authors | NHLBI PETAL Network |
Journal | J Crit Care |
Volume | 71 |
Pagination | 154118 |
Date Published | 2022 Oct |
ISSN | 1557-8615 |
Keywords | Humans, 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. |
DOI | 10.1016/j.jcrc.2022.154118 |
Alternate Journal | J Crit Care |
PubMed ID | 35905586 |
PubMed Central ID | PMC9419605 |
Grant List | U01 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 |