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Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements
OBJECTIVE: During March 2020 in the United States, demand for sedatives increased by 91%, that for analgesics rose by 79%, and demand for neuromuscular blockers increased by 105%, all owing to the number of COVID-19 cases requiring invasive mechanical ventilation (MV). We hypothesize that analgesic...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706048/ https://www.ncbi.nlm.nih.gov/pubmed/36408532 http://dx.doi.org/10.1177/03000605221138487 |
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author | Wiemann, Brianne Mitchell, Jessica Sarangarm, Preeyaporn Miskimins, Richard |
author_facet | Wiemann, Brianne Mitchell, Jessica Sarangarm, Preeyaporn Miskimins, Richard |
author_sort | Wiemann, Brianne |
collection | PubMed |
description | OBJECTIVE: During March 2020 in the United States, demand for sedatives increased by 91%, that for analgesics rose by 79%, and demand for neuromuscular blockers increased by 105%, all owing to the number of COVID-19 cases requiring invasive mechanical ventilation (MV). We hypothesize that analgesic and sedative requirements decrease following tracheotomy in this patient population. METHODS: In this cross-sectional study, we conducted a retrospective chart review to identify patients with COVID-19 who underwent tracheotomy (T) at an academic medical center between March 2020 and January 2021. We used a paired Student t-test to compare total oral morphine equivalents (OMEs), total lorazepam equivalents, 24-hour average dexmedetomidine dosage in μg/kg/hour, and 24-hour average propofol dosage in μg/kg/minute on days T−1 and T+2 for each patient. RESULTS: Of 50 patients, 46 required opioids before and after tracheotomy (mean decrease of 49.4 mg OMEs). Eight patients required benzodiazepine infusion (mean decrease of 45.1 mg lorazepam equivalents. Fifteen patients required dexmedetomidine infusion (mean decrease 0.34 μg/kg/hour). Seventeen patients required propofol (mean decrease 20.5 μg/kg/minute). CONCLUSIONS: When appropriate personal protective equipment is available, use of tracheotomy in patients with COVID-19 who require MV may help to conserve medication supplies in times of extreme shortages. |
format | Online Article Text |
id | pubmed-9706048 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-97060482022-11-30 Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements Wiemann, Brianne Mitchell, Jessica Sarangarm, Preeyaporn Miskimins, Richard J Int Med Res Retrospective Clinical Research Report OBJECTIVE: During March 2020 in the United States, demand for sedatives increased by 91%, that for analgesics rose by 79%, and demand for neuromuscular blockers increased by 105%, all owing to the number of COVID-19 cases requiring invasive mechanical ventilation (MV). We hypothesize that analgesic and sedative requirements decrease following tracheotomy in this patient population. METHODS: In this cross-sectional study, we conducted a retrospective chart review to identify patients with COVID-19 who underwent tracheotomy (T) at an academic medical center between March 2020 and January 2021. We used a paired Student t-test to compare total oral morphine equivalents (OMEs), total lorazepam equivalents, 24-hour average dexmedetomidine dosage in μg/kg/hour, and 24-hour average propofol dosage in μg/kg/minute on days T−1 and T+2 for each patient. RESULTS: Of 50 patients, 46 required opioids before and after tracheotomy (mean decrease of 49.4 mg OMEs). Eight patients required benzodiazepine infusion (mean decrease of 45.1 mg lorazepam equivalents. Fifteen patients required dexmedetomidine infusion (mean decrease 0.34 μg/kg/hour). Seventeen patients required propofol (mean decrease 20.5 μg/kg/minute). CONCLUSIONS: When appropriate personal protective equipment is available, use of tracheotomy in patients with COVID-19 who require MV may help to conserve medication supplies in times of extreme shortages. SAGE Publications 2022-11-20 /pmc/articles/PMC9706048/ /pubmed/36408532 http://dx.doi.org/10.1177/03000605221138487 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Retrospective Clinical Research Report Wiemann, Brianne Mitchell, Jessica Sarangarm, Preeyaporn Miskimins, Richard Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements |
title | Tracheotomy in ventilator-dependent patients with COVID-19: a
cross-sectional study of analgesia and sedative requirements |
title_full | Tracheotomy in ventilator-dependent patients with COVID-19: a
cross-sectional study of analgesia and sedative requirements |
title_fullStr | Tracheotomy in ventilator-dependent patients with COVID-19: a
cross-sectional study of analgesia and sedative requirements |
title_full_unstemmed | Tracheotomy in ventilator-dependent patients with COVID-19: a
cross-sectional study of analgesia and sedative requirements |
title_short | Tracheotomy in ventilator-dependent patients with COVID-19: a
cross-sectional study of analgesia and sedative requirements |
title_sort | tracheotomy in ventilator-dependent patients with covid-19: a
cross-sectional study of analgesia and sedative requirements |
topic | Retrospective Clinical Research Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706048/ https://www.ncbi.nlm.nih.gov/pubmed/36408532 http://dx.doi.org/10.1177/03000605221138487 |
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