title: Duration of mechanical ventilation in an adult intensive care unit after introduction of sedation and pain scales.
abstract: BACKGROUND
  Sedation and analgesia scales promote a less-distressing experience in the intensive care unit and minimize complications for patients receiving mechanical ventilation.
  
  
  OBJECTIVE
  To evaluate outcomes before and after introduction of scales for sedation and analgesia in a general intensive care unit.
  
  
  METHODS
  A before-and-after design was used to evaluate introduction of the Richmond Agitation-Sedation Scale and the Behavioral Pain Scale for patients receiving mechanical ventilation. Data were collected for 6 months before and 6 months after training in and introduction of the scales.
  
  
  RESULTS
  A total of 769 patients received mechanical ventilation for at least 6 hours (369 patients before and 400 patients after implementation). Age, scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II, and diagnostic groups were similar in the 2 groups, but the after group had more men than did the before group. Duration of mechanical ventilation did not change significantly after the scales were introduced (median, 24 vs 28 hours). For patients who received mechanical ventilation for 96 hours or longer (24%), mechanical ventilation lasted longer after implementation of the scales (P=.03). Length of stay in the intensive care unit was similar in the 2 groups (P= .18), but patients received sedatives for longer after implementation (P=.01). By logistic regression analysis, APACHE II score (P<.001) and diagnostic group (P<.001) were independent predictors of mechanical ventilation lasting 96 hours or longer.
  
  
  CONCLUSIONS
  Sedation and analgesia scales did not reduce duration of ventilation in an Australian intensive care unit.
authors.affiliation: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia. teresa.williams@health.wa.gov.au
authors.forename: Teresa Ann
authors.initials: TA
authors.lastname: Williams
authors.forename: Suzanne
authors.initials: S
authors.lastname: Martin
authors.forename: Gavin
authors.initials: G
authors.lastname: Leslie
authors.forename: Linda
authors.initials: L
authors.lastname: Thomas
authors.forename: Timothy
authors.initials: T
authors.lastname: Leen
authors.forename: Sheralee
authors.initials: S
authors.lastname: Tamaliunas
authors.forename: K Y
authors.initials: KY
authors.lastname: Lee
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Dobb
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods*; D003625:Data Collection / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012121:Respiration, Artificial / Q000379:methods*; D013997:Time Factors