Author/Authors :
Kim, Taehee Department of Pulmonary - Allergy and Critical Care Medicine - Hallym University Kangnam Sacred Heart Hospital - Seoul, Korea , Kim, Jung Soo Department of Pulmonary and Critical Care Medicine - Inha University College of Medicine - Incheon, Korea , Choi, Eun Young Department of Pulmonary and Critical Care Medicine - Yeungnam University Hospital - Daegu, Korea , Chang, Youjin Department of Pulmonary and Critical Care Medicine - Inje University Sanggye Paik Hospital - Seoul, Korea , Choi, Won-Il Department of Internal Medicine - Myongji Hospital, Korea , Hwang, Jae-Joon Department of Pulmonary and Critical Care Medicine - Kyung Hee University Hospital at Gangdong - Seoul, Korea , Moon, Jae Young Department of Pulmonary and Critical Care Medicine - Chungnam National University Hospital - Daejeon, Korea , Lee, Kwangha Department of Internal Medicine - Pusan National University Hospital - Busan, Korea , Kim, Sei Won Department of Pulmonary - Critical Care and Sleep Medicine - St. Paul’s Hospital - College of Medicine - The Catholic University of Korea - Seoul, Korea , Kang, Hyung Koo Department of Internal Medicine - Inje University Ilsan Paik Hospital - Goyang, Korea , Sim, Yun Su Department of Pulmonary - Allergy and Critical Care Medicine - Hallym University Kangnam Sacred Heart Hospital - Seoul, Korea , Park, Tai Sun Department of Internal Medicine - Hanyang University Guri Hospital - Guri, Korea , Park, Seung Yong Department of Pulmonary - Allergy and Critical Care Medicine - Jeonbuk National University Hospital -Jeonbuk, Korea , Park, Sunghoon Department of Pulmonary - Allergy and Critical Care Medicine - Hallym University Sacred Heart Hospital - Anyang, Korea , Cho, Jae Hwa Department of Internal Medicine - Gangnam Severance Hospital - Yonsei University College of Medicine - Seoul, Korea
Abstract :
Background: The use of sedative drugs may be an important therapeutic intervention during
noninvasive ventilation (NIV) in intensive care units (ICUs). The purpose of this study was to
assess the current application of analgosedation in NIV and its impact on clinical outcomes in
Korean ICUs.
Methods: Twenty Korean ICUs participated in the study, and data was collected on NIV use
during the period between June 2017 and February 2018. Demographic data from all adult
patients, NIV clinical parameters, and hospital mortality were included.
Results: A total of 155 patients treated with NIV in the ICUs were included, of whom 26 received pain and sedation therapy (sedation group) and 129 did not (control group). The primary cause of ICU admission was due to acute exacerbation of obstructed lung disease (45.7%) in
the control group and pneumonia treatment (53.8%) in the sedation group. In addition, causes
of NIV application included acute hypercapnic respiratory failure in the control group (62.8%)
and post-extubation respiratory failure in the sedation group (57.7%). Arterial partial pressure
of carbon dioxide (PaCO2) levels before and after 2 hours of NIV treatment were significantly
decreased in both groups: from 61.9±23.8 mm Hg to 54.9±17.6 mm Hg in the control group
(P<0.001) and from 54.9±15.1 mm Hg to 51.1±15.1 mm Hg in the sedation group (P=0.048).
No significant differences were observed in the success rate of NIV weaning, complications,
length of ICU stay, ICU survival rate, or hospital survival rate between the groups.
Conclusions: In NIV patients, analgosedation therapy may have no harmful effects on complications, NIV weaning success, and mortality compared to the control group. Therefore, sedation during NIV may not be unsafe and can be used in patients for pain control when indicated.
