Abstract
Introduction: Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). The current study was conducted to determine the effect of a protocol using a Richmond Agitation-Sedation Scale (RASS) on some clinical outcomes of patients under mechanical ventilation (MV) in 2017.Methods: This single-blind clinical trial was conducted on 79 traumatic patients in the ICU who were randomly allocated into the intervention (N=40) and the control groups (N=39). The sedation was achieved, using a sedation protocol in the intervention group and the routine care in the control group. The clinical outcomes of the patients (duration of MV, length of staying in ICU, final outcome) were measured. As the participants had different lengths of MV and staying in ICU, the data were restructured, and were analyzed, using proper statistical methods.Results: The patients’ level of sedation in the intervention group was significantly closer to the ideal score of RASS (-1 to +1). The duration of MV was significantly reduced in the intervention group, and the length of stay in the ICU was also significantly shorter. There was no difference in terms of final outcome. The ICU cost in the control group was twice as high as the cost in of the intervention group.Conclusion: The applied sedation protocol in this study would provide better sedation and could consequently lead to significantly better clinical outcomes, and the cost of caring as a result.
Highlights
Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU)
As the number of days under mechanical ventilation (MV) was not uniform in the two groups, the restructuring as well as appropriate statistical tests were employed to compare the frequency of Richmond Agitation-Sedation Scale (RASS) scores during MV based on a day, morning, evening, and night shifts, duration of MV, length of ICU stay, and clinical outcomes
The results of Fisher's exact test suggested that the RASS scores of the intervention group who used the sedation protocol were significantly in the ideal range (-1, 0, and 1) (P
Summary
Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). Conclusion: The applied sedation protocol in this study would provide better sedation and could lead to significantly better clinical outcomes, and the cost of caring as a result. According to US statistics, 55,000 patients are hospitalized daily in the ICU for various reasons.[1] Mechanical Ventilation (MV) is required in over 90% of adult patients with critical illness in ICUs.[2] it saves the lives of tens of thousands of patients with oxygenation problems, it simultaneously causes many complications in these patients and is associated with a high mortality rate.[3] The Long-term MV refers to MV more than 3 days, which can increase health care costs, such as MV related costs and mortality.[4]. Unplanned extubating is a major complication of the endotracheal intubation.[6] resulting in the long-term MV, long term length of stay in ICU, and even in some cases, mortality.[7]
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