• Am. J. Crit. Care · Mar 2020

    Observational Study

    Patient-Reported Outcomes Associated With Sedation and Agitation Intensity in the Critically Ill.

    • Ashleigh Malinowski, Neal J Benedict, Meng-Ni Ho, Levent Kirisci, and Sandra L Kane-Gill.
    • Ashleigh Malinowski is a clinical pharmacist in the surgical/trauma intensive care unit, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
    • Am. J. Crit. Care. 2020 Mar 1; 29 (2): 140-144.

    BackgroundPatient-reported outcomes are essential to understand the relationship between patients' perception of sedation and clinicians' assessments of sedation.ObjectivesTo evaluate the association between sedation and agitation indexes and patient-reported outcomes of sedation and analgesia.MethodsThis prospective, single-center, observational study included adult patients who were continuously sedated for at least 24 hours in a medical or surgical/ trauma intensive care unit. Patients were interviewed after sedation was discontinued regarding their satisfaction with the quality of sedation and potentially related factors. The primary outcome was the correlation between sedation and agitation indexes and patient-reported outcomes.ResultsA total of 68 patients were interviewed after sedation. Of these, 29 (42.6%) described their overall feelings about their experience while receiving mechanical ventilation in the intensive care unit as "pleasant". When asked about their desires if they were to experience the situation again, 29 patients (42.6%) reported that they would want more sedation. Agitation index was statistically significantly correlated with several patient-reported outcomes. Receiving mechanical ventilation (r = 0.41, P = .002), the amount of noise (r = 0.34, P = .01), suctioning (r = 0.32, P = .02), difficulty resting or sleeping (r = 0.39, P = .003), inability to communicate by talking (r = 0.36, P = .008), anxiety (r = 0.29, P = .03), panic (r = 0.3, P = .02), and frustration (r = 0.47, P < .001) were associated with a higher agitation index.ConclusionAgitation index was significantly associated with several patient-reported outcomes and thus seems to be a promising descriptor of patients' experience.©2020 American Association of Critical-Care Nurses.

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