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Rev Bras Ter Intensiva · Dec 2008
Ramsay and Richmond's scores are equivalent to assessment sedation level on critical patients.
- Ciro Leite Mendes, Lívia Carolina Santos Vasconcelos, Jordana Soares Tavares, Silvia Borges Fontan, Daniela Coelho Ferreira, Lígia Almeida Carlos Diniz, Elayne Souza Alves, Erick José Morais Villar, César de Farias Albuquerque, and Sérgio Luz Domingues da Silva.
- Unidade de Terapia Intensiva, Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brasil.
- Rev Bras Ter Intensiva. 2008 Dec 1;20(4):344-8.
ObjectiveThe main purpose of this study was to compare performance of the Ramsay and Richmond sedation scores on mechanically ventilated critically ill patients, in a university-affiliated hospital.MethodsThis was a 4-month prospective study, which included a total of 45 patients mechanically ventilated, with at least 48 hours stay in the intensive care unit. Each patient was assessed daily for sedation mode, sedative and analgesic doses and sedation level using the Ramsay and Richmond scores. Statistical analysis was made using Student's t-test, Pearson's and Spearman's correlation, and constructing ROC-curves.ResultsA high general mortality of 60% was observed. The length of sedation and daily dose of medication did not correlate with mortality. Deep sedation (Ramsay > 4 or Richmond < -3) was positively correlated with probability of death with an AUC > 0.78. An adequate level of sedation (Ramsay 2 to 4 or Richmond 0 to -3) was sensitively correlated with probability of survival with an AUC > 0.80. A low level of sedation was observed in 63 days evaluated (8.64%), and no correlation was found between occurrence of agitation and unfavorable outcomes. Correlation between Ramsay and Richmond scores (Pearson's > 0.810 - p<0.0001) was good.ConclusionIn this study, Ramsay and Richmond sedation scores were similar for the assessment of deep, insufficient and adequate sedation. Both have good correlation with mortality in over sedated patients.
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