title: Practice of sedation and the perception of discomfort during mechanical ventilation in Chinese intensive care units.
abstract: 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.
authors.affiliation: Department of Critical Care Medicine, The Second Affiliated Hospital, Chinese People's Liberation Army General Hospital, Beijing 100091, China. mapenglin1@163.com
authors.forename: Penglin
authors.initials: P
authors.lastname: Ma
authors.forename: Jingtao
authors.initials: J
authors.lastname: Liu
authors.forename: Xiuming
authors.initials: X
authors.lastname: Xi
authors.forename: Bin
authors.initials: B
authors.lastname: Du
authors.forename: Xu
authors.initials: X
authors.lastname: Yuan
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Lin
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Jinwen
authors.initials: J
authors.lastname: Su
authors.forename: Lin
authors.initials: L
authors.lastname: Zeng
mesh_terms: 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
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives