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>Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study
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Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study
Background: The use of sedative drugs may be an important therapeutic intervention during noninvasive ventilation (NIV) in intensive care units (ICUs). The purpose of this study was to assess the current application of analgosedation in NIV and its impact on clinical outcomes in Korean ICUs. Methods: Twenty Korean ICUs participated in the study, and data was collected on NIV use during the period between June 2017 and February 2018. Demographic data from all adult patients, NIV clinical parameters, and hospital mortality were included. Results: A total of 155 patients treated with NIV in the ICUs were included, of whom 26 received pain and sedation therapy (sedation group) and 129 did not (control group). The primary cause of ICU admission was due to acute exacerbation of obstructed lung disease (45.7%) in the control group and pneumonia treatment (53.8%) in the sedation group. In addition, causes of NIV application included acute hypercapnic respiratory failure in the control group (62.8%) and post-extubation respiratory failure in the sedation group (57.7%). Arterial partial pressure of carbon dioxide (PaCO2) levels before and after 2 hours of NIV treatment were significantly decreased in both groups: from 61.9±23.8 mm Hg to 54.9±17.6 mm Hg in the control group (P0.001) and from 54.9±15.1 mm Hg to 51.1±15.1 mm Hg in the sedation group (P=0.048). No significant differences were observed in the success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, or hospital survival rate between the groups. Conclusions: In NIV patients, analgosedation therapy may have no harmful effects on complications, NIV weaning success, and mortality compared to the control group. Therefore, sedation during NIV may not be unsafe and can be used in patients for pain control when indicated.
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机译：背景：镇静药物的使用可能是在重症监护单位（ICU）中的非侵入性通气（NIV）期间的重要治疗干预。本研究的目的是评估目前在NIV中的分析及其对韩国疾病危险临床结果的影响。方法：二十次韩国ICU参加了该研究，并在2017年6月和2018年2月期间收集了NIV使用的数据。来自所有成年患者，NIV临床参数和医院死亡率的人口统计数据。结果：含有尼弗治疗的155名患者，其中26名接受疼痛和镇静治疗（镇静组）和129次没有（对照组）。 ICU入院的主要原因是由于镇静组对照组和肺炎治疗（53.8％）的阻塞肺病（45.7％）的急剧加剧。此外，NIV申请的原因包括对照组（62.8％）和镇静组中的急性高潮呼吸衰竭，镇静组（57.7％）。两组核育治疗前后二氧化碳（PACO2）水平的动脉分压（PACO2）水平在两组中显着降低：对照组（P <0.001）和54.9±54.9±23.8mm Hg至54.9±17.6 mm Hg。镇静组15.1毫米至51.1±15.1毫米Hg（P = 0.048）。在核心断奶，并发症，ICU的长度，ICU生存率或群体之间的医院存活率的成功率没有显着差异。结论：在NIV患者中，Analgosation治疗可能对并发症的影响无害，NIV断奶成功和死亡率与对照组相比。因此，在NIV期间的镇静可能不是不安全并且在指出时可用于患者疼痛控制。
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