[EngO1-4] Current status of pain and sedation therapy on noninvasive mechanical ventilation in Korean Intensive Care Units: a multi-center observational study
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INTRODUCTION
The use of sedative drugs may be an important therapeutic intervention in patients with high risks such as mask intolerance, delirium, and agitation. However, there is little data on sedation during NIV maintenance. The Korean noninvasive mechanical ventilation study group has prospectively collected NIV use data from ICUs.
OBJECTIVES
We analyzed status and safety in the management of pain, sedation on NIV therapy in Korean ICU.
METHODS
The twenty ICUs intensivists among Korean nationwide hospitals were participated and collected data of NIV from June 2017 to April 2018. Demographic data of patients, clinical parameters of NIV, hospital mortality were included. We analyzed using chi-square test and Fisher’s exact test on categorical variables and Mann-Whitney U test on continuous variables.
RESULTS
The 155 patients were included during those periods. We divided the intervention group (n=26) that who received management of pain, sedation and control group (n=129). The PaCO2 and PaO2/FiO2 ratio before NIV and 30 minutes after NIV were not different between intervention and control group. There was no statistically significant difference in success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, and hospital survival rate. However, duration of NIV apply were shorter in intervention than in control (1.5 days versus 4 days, p=0.001).
CONCLUSION
In the NIV patients, pain and sedation therapy had no harmful effect on complications, NIV weaning success, and mortality compared to the control group but significantly reduced the duration of NIV. Thus control of pain, sedation during NIV might be safe so it can be used in patients with indication.
The use of sedative drugs may be an important therapeutic intervention in patients with high risks such as mask intolerance, delirium, and agitation. However, there is little data on sedation during NIV maintenance. The Korean noninvasive mechanical ventilation study group has prospectively collected NIV use data from ICUs.
OBJECTIVES
We analyzed status and safety in the management of pain, sedation on NIV therapy in Korean ICU.
METHODS
The twenty ICUs intensivists among Korean nationwide hospitals were participated and collected data of NIV from June 2017 to April 2018. Demographic data of patients, clinical parameters of NIV, hospital mortality were included. We analyzed using chi-square test and Fisher’s exact test on categorical variables and Mann-Whitney U test on continuous variables.
RESULTS
The 155 patients were included during those periods. We divided the intervention group (n=26) that who received management of pain, sedation and control group (n=129). The PaCO2 and PaO2/FiO2 ratio before NIV and 30 minutes after NIV were not different between intervention and control group. There was no statistically significant difference in success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, and hospital survival rate. However, duration of NIV apply were shorter in intervention than in control (1.5 days versus 4 days, p=0.001).
CONCLUSION
In the NIV patients, pain and sedation therapy had no harmful effect on complications, NIV weaning success, and mortality compared to the control group but significantly reduced the duration of NIV. Thus control of pain, sedation during NIV might be safe so it can be used in patients with indication.