The relationship between sedative infusion requirements and permissive hypercapnia in critically ill, mechanically ventilated patients

Critical Care Medicine
Ajeet VinayakJ P Kress

Abstract

Permissive hypercapnia (PH) may result from mechanical ventilation (MV) strategies that intentionally reduce minute ventilation. Sedative doses required to tolerate PH have not been well characterized. With increased attention to lung-protective ventilation, characterization of sedative requirements with PH and determination of sedative dose changes with PH are needed. Retrospective analysis. Tertiary care university hospital. We evaluated 124 patients randomized in a previous study to either propofol or midazolam. PH was employed in ten of 60 patients receiving propofol and 13 of 64 patients receiving midazolam. We analyzed dosing of propofol and midazolam in patients undergoing PH through a retrospective analysis of an existing database on MV patients. Total sedative (propofol and midazolam) dose was recorded for the first three days of MV. Linear regression analysis (dependent variable: sedative dose) was used to analyze the following independent variables: PH, age, gender, daily sedative interruption, type of respiratory failure, presence of hepatic and/or renal failure, Acute Physiology and Chronic Health Evaluation II score, morphine dose, and Ramsay sedation score. Propofol dose was higher in PH patients (42.5+/-16.2 vs....Continue Reading

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Citations

May 23, 2006·Critical Care Medicine·Bernard De Jonghe
Oct 16, 2002·American Journal of Respiratory and Critical Care Medicine·John P KressJesse B Hall
Jun 19, 2013·Medicina intensiva·E Celis-RodríguezUNKNOWN Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva
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Jan 17, 2012·Current Opinion in Anaesthesiology·Alawi LuetzClaudia Spies
Apr 7, 2007·Current Opinion in Anaesthesiology

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