論文

査読有り
2016年10月

The relationship between sedative drug utilization and outcomes in critically ill patients undergoing mechanical ventilation

JOURNAL OF ANESTHESIA
  • Kenshi Hayashida
  • ,
  • Takeshi Umegaki
  • ,
  • Hiroshi Ikai
  • ,
  • Genki Murakami
  • ,
  • Masaji Nishimura
  • ,
  • Yuichi Imanaka

30
5
開始ページ
763
終了ページ
769
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00540-016-2196-z
出版者・発行元
SPRINGER JAPAN KK

The objectives of this study were to describe current sedative drug utilization patterns in critically ill patients undergoing mechanical ventilation (MV) in intensive care units (ICUs) in Japanese hospitals and to elucidate the relationship of these utilization patterns with patient clinical outcomes.
Analysis of hospital claims data derived from the Quality Indicator/Improvement Project identified 12,395 critically ill adult patients who had undergone MV while hospitalized in the ICUs of 114 Japanese hospitals and had been discharged between April 2008 and March 2010. Descriptive statistics were calculated for the daily utilization of sedative drugs, opioids, and muscle relaxants in this patient sample, and the relationship between drug utilization and patient outcomes using Cox proportional hazards analysis were examined.
Of the 12,395 patients included in the analysis, 7300 (58.9 %), 580 (4.7 %), and 671 (5.4 %) received sedative drugs, opioids, and muscle relaxants, respectively, for aeyen2 days after intubation. Compared to the other patient groups, there was a higher proportion of males in the group given sedative drugs and the patients were significantly younger (P < 0.001). Propofol was the most frequently used sedative drug, followed by benzodiazepines, barbiturates, and dexmedetomidine. The mortality rate was lower and ventilator weaning was earlier among patients who received only propofol than among those who received only benzodiazepines. Muscle relaxants were associated with increased duration of MV.
This is the first study based on a large-scale analysis in Japan to elucidate sedative drug utilization patterns and their relationship with outcomes in critically ill patients. The most commonly used sedative was propofol, which was associated with favorable patient outcomes. Further prospective research must be conducted to discern effective sedative drug utilization.

リンク情報
DOI
https://doi.org/10.1007/s00540-016-2196-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/27312979
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000384883200004&DestApp=WOS_CPL
ID情報
  • DOI : 10.1007/s00540-016-2196-z
  • ISSN : 0913-8668
  • eISSN : 1438-8359
  • PubMed ID : 27312979
  • Web of Science ID : WOS:000384883200004

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