Cargando…

Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS

Objectives: To assess differences in the use of analgesics, sedatives and neuromuscular-blocking agents (NMBA) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19 or other conditions. Methods: Retrospective observational cohort study, single-center tertiary Intensive Care Uni...

Descripción completa

Detalles Bibliográficos
Autores principales: Ego, Amédée, Peluso, Lorenzo, Gorham, Julie, Diosdado, Alberto, Restuccia, Giovanni, Creteur, Jacques, Taccone, Fabio Silvio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624865/
https://www.ncbi.nlm.nih.gov/pubmed/34835518
http://dx.doi.org/10.3390/microorganisms9112393
_version_ 1784606278627098624
author Ego, Amédée
Peluso, Lorenzo
Gorham, Julie
Diosdado, Alberto
Restuccia, Giovanni
Creteur, Jacques
Taccone, Fabio Silvio
author_facet Ego, Amédée
Peluso, Lorenzo
Gorham, Julie
Diosdado, Alberto
Restuccia, Giovanni
Creteur, Jacques
Taccone, Fabio Silvio
author_sort Ego, Amédée
collection PubMed
description Objectives: To assess differences in the use of analgesics, sedatives and neuromuscular-blocking agents (NMBA) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19 or other conditions. Methods: Retrospective observational cohort study, single-center tertiary Intensive Care Unit. COVID-19 patients with ARDS (March–May 2020) and non-COVID ARDS patients (2017–2020) on mechanical ventilation and receiving sedation for at least 48 h. Results: A total of 39 patients met the inclusion criteria in each group, with similar demographics at baseline. COVID-19 patients had a longer duration of MV (median 22 (IQRs 16–29) vs. 9 (6–18) days; p < 0.01), of sedatives administration (18 (11–22) vs. 5 (4–9) days; p < 0.01) and NMBA therapy (12 (9–16) vs. 3 (2–7) days; p < 0.01). During the first 7 days of sedation, compared to non-COVID patients, COVID patients received more frequently a combination of multiple sedative drugs (76.9% vs. 28.2%; p < 0.01) and a higher NMBA regimen (cisatracurium: 3.0 (2.1–3.7) vs. 1.3 (0.9–1.9) mg/kg/day; p < 0.01). Conclusions: The duration and consumption of sedatives and NMBA was significantly increased in patients with COVID-19 related ARDS than in non-COVID ARDS. Different sedation strategies and protocols might be needed in COVID-19 patients with ARDS, with potential implications on long-term complications and drugs availability.
format Online
Article
Text
id pubmed-8624865
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-86248652021-11-27 Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS Ego, Amédée Peluso, Lorenzo Gorham, Julie Diosdado, Alberto Restuccia, Giovanni Creteur, Jacques Taccone, Fabio Silvio Microorganisms Article Objectives: To assess differences in the use of analgesics, sedatives and neuromuscular-blocking agents (NMBA) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19 or other conditions. Methods: Retrospective observational cohort study, single-center tertiary Intensive Care Unit. COVID-19 patients with ARDS (March–May 2020) and non-COVID ARDS patients (2017–2020) on mechanical ventilation and receiving sedation for at least 48 h. Results: A total of 39 patients met the inclusion criteria in each group, with similar demographics at baseline. COVID-19 patients had a longer duration of MV (median 22 (IQRs 16–29) vs. 9 (6–18) days; p < 0.01), of sedatives administration (18 (11–22) vs. 5 (4–9) days; p < 0.01) and NMBA therapy (12 (9–16) vs. 3 (2–7) days; p < 0.01). During the first 7 days of sedation, compared to non-COVID patients, COVID patients received more frequently a combination of multiple sedative drugs (76.9% vs. 28.2%; p < 0.01) and a higher NMBA regimen (cisatracurium: 3.0 (2.1–3.7) vs. 1.3 (0.9–1.9) mg/kg/day; p < 0.01). Conclusions: The duration and consumption of sedatives and NMBA was significantly increased in patients with COVID-19 related ARDS than in non-COVID ARDS. Different sedation strategies and protocols might be needed in COVID-19 patients with ARDS, with potential implications on long-term complications and drugs availability. MDPI 2021-11-20 /pmc/articles/PMC8624865/ /pubmed/34835518 http://dx.doi.org/10.3390/microorganisms9112393 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ego, Amédée
Peluso, Lorenzo
Gorham, Julie
Diosdado, Alberto
Restuccia, Giovanni
Creteur, Jacques
Taccone, Fabio Silvio
Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title_full Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title_fullStr Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title_full_unstemmed Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title_short Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS
title_sort use of sedatives and neuromuscular-blocking agents in mechanically ventilated patients with covid-19 ards
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624865/
https://www.ncbi.nlm.nih.gov/pubmed/34835518
http://dx.doi.org/10.3390/microorganisms9112393
work_keys_str_mv AT egoamedee useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT pelusolorenzo useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT gorhamjulie useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT diosdadoalberto useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT restucciagiovanni useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT creteurjacques useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards
AT tacconefabiosilvio useofsedativesandneuromuscularblockingagentsinmechanicallyventilatedpatientswithcovid19ards