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Titolo:
Utilization patterns, relative costs, and length of stay following adoption of MICU sedation guidelines
Autore:
Bobek, MB; Hoffman-Hogg, L; Bair, N; Slomka, J; Mion, LC; Arroliga, AC;
Indirizzi:
Coastal Area Hlth Educ Ctr, Wilmington, NC USA Coastal Area Hlth Educ CtrWilmington NC USA duc Ctr, Wilmington, NC USA
Titolo Testata:
FORMULARY
fascicolo: 9, volume: 36, anno: 2001,
pagine: 664 -
SICI:
1082-801X(200109)36:9<664:UPRCAL>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTENSIVE-CARE UNIT; CRITICALLY-ILL PATIENTS; NEUROMUSCULAR-BLOCKING-AGENTS; MECHANICAL VENTILATION; PRACTICE PARAMETERS; NATIONAL SURVEY; MIDAZOLAM; PROPOFOL; ANALGESICS; ICU;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Bobek, MB Coastal Area Hlth Educ Ctr, Wilmington, NC USA Coastal Area HlthEduc Ctr Wilmington NC USA ilmington, NC USA
Citazione:
M.B. Bobek et al., "Utilization patterns, relative costs, and length of stay following adoption of MICU sedation guidelines", FORMULARY, 36(9), 2001, pp. 664

Abstract

Objective: To determine patterns and frequency of sedative, analgesic, andneuromuscular blocker (NMB) use in a medical intensive care unit (MICU); to describe drug costs, and to describe MICU length of stay and self-extubation related to medication use following implementation of sedation guidelines. Design: Prospective cohort study. Subjects., One hundred patients requiring mechanical ventilation consecutively admitted to an MICU. Measurement. The following data were concurrently collected from medical records: demographic characteristics; clinical variables; sedative, analgesic, and NMB use; MICU length of stay; and self-extubation events. Results: The 85 patients who received a study medication were given a mean of 2.5 (+/-1.5) medications each. Morphine was the most commonly used analgesic (n = 39), primarily as an as-needed bolus. Fentanyl exceeded morphine in acquisition cost anddays of use even at equipotent doses. Lorazepam was the most commonly used(n = 71) and least expensive sedative. Only 12 patients received an NMB. Length. of stay was associated with the number of drug classes received (p =0.0002) but not with the type of drug used. Fifty-nine patients received two or more drugs, usually a benzodiazepine and an analgesic. Conclusions. Benzodiazepines were used more often than analgesics in the MICU. Most patients received lorazepam and morphine on an as-needed basis, as specified by the guidelines, at less cost than with continuous infusion. There was no evidence that as-needed use of morphine or lorazepam increased MICU length ofstay or self-extubation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/01/20 alle ore 19:07:28