The ED-SED Study: A Multicenter, Prospective Cohort Study of Practice Patterns and Clinical Outcomes Associated With Emergency Department SEDation for Mechanically Ventilated Patients

Critical Care Medicine
Brian M FullerMichael S Avidan

Abstract

To characterize emergency department sedation practices in mechanically ventilated patients, and test the hypothesis that deep sedation in the emergency department is associated with worse outcomes. Multicenter, prospective cohort study. The emergency department and ICUs of 15 medical centers. Mechanically ventilated adult emergency department patients. None. All data involving sedation (medications, monitoring) were recorded. Deep sedation was defined as Richmond Agitation-Sedation Scale of -3 to -5 or Sedation-Agitation Scale of 2 or 1. A total of 324 patients were studied. Emergency department deep sedation was observed in 171 patients (52.8%), and was associated with a higher frequency of deep sedation in the ICU on day 1 (53.8% vs 20.3%; p < 0.001) and day 2 (33.3% vs 16.9%; p = 0.001), when compared to light sedation. Mean (SD) ventilator-free days were 18.1 (10.8) in the emergency department deep sedation group compared to 20.0 (9.8) in the light sedation group (mean difference, 1.9; 95% CI, -0.40 to 4.13). Similar results according to emergency department sedation depth existed for ICU-free days (mean difference, 1.6; 95% CI, -0.54 to 3.83) and hospital-free days (mean difference, 2.3; 95% CI, 0.26-4.32). Mortality was ...Continue Reading

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Citations

Dec 18, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Brendan P GeorgeAzeemuddin Ahmed
Jan 14, 2020·Therapeutic Hypothermia and Temperature Management·Graham NicholMarkus Ferrari
Oct 2, 2020·Journal of the American College of Emergency Physicians Open·Clifford L FreemanTyler W Barrett
Jan 18, 2021·Annals of Emergency Medicine·Michael Gottlieb, Jestin N Carlson
Mar 9, 2021·Chest·Shannon M FernandoKwadwo Kyeremanteng
Mar 30, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Tessa L SteelCatherine L Hough
Dec 15, 2020·Acta Anaesthesiologica Scandinavica·Thomas P ClydeBrian W Roberts
Jun 30, 2021·The American Journal of Emergency Medicine·Alyssa May, Kevin Lynch
Oct 20, 2020·The American Journal of Emergency Medicine·Skyler LentzBrit Long

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