Practice of sedation and the perception of discomfort during mechanical ventilation in Chinese intensive care units.
OBJECTIVE
The purpose of this study was to investigate sedation practices and the perception of discomfort during mechanical ventilation in Chinese intensive care units (ICUs).


METHODS
A prospective, observational, cohort study was conducted in 31 Chinese ICUs in academic hospitals from June 15 to August 15, 2006. Conscious patients who were discharged from the ICU after mechanical ventilation were consecutively included. Using a standardized questionnaire, a personal interview was conducted with each patient within 2 days after discharge from the ICU. Patients were asked about recollections of emotional and physical discomfort. Sedation and analgesia administration data were collected from patient records.


RESULTS
As prospectively defined, 83 (50.9%) of 163 patients met criteria for complex-mixed discomfort (ie, at least 1 emotional and 2 physical disturbances). Similarly, 79.1% of patients remembered seriously uncomfortable experiences associated with 1 of the 3 predefined sources. Both protocolized sedation and continuous sedation without a defined protocol, but not intermittent sedation, significantly reduced the relative risk of complex-mixed discomfort occurrences (P < .001). Notably, only 14.7% of patients received protocolized sedation, and 61 (37.4%) of 163 were not given any sedatives.


CONCLUSIONS
Mechanically ventilated ICU patients in Chinese academic hospitals were inadequately treated for discomfort. Protocolized sedation can effectively improve patient comfort.
Ma
Penglin
P
Department of Critical Care Medicine, The Second Affiliated Hospital, Chinese People's Liberation Army General Hospital, Beijing 100091, China. mapenglin1@163.com
Liu
Jingtao
J
Xi
Xiuming
X
Du
Bin
B
Yuan
Xu
X
Lin
Hongyuan
H
Wang
Yu
Y
Su
Jinwen
J
Zeng
Lin
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D002681:China; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007362:Intensive Care Units; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D058748:Pain Perception; D011446:Prospective Studies; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000523:psychology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult
D000700:Analgesics; D006993:Hypnotics and Sedatives