Abanador-Kamper Nadine, Wolfertz Judith, Thürmann Petra, Kamper Lars, Seyfarth Melchior
Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Arrenberger Straße 20, 42117 Wuppertal, Germany ; Center for Clinical and Translational Research, HELIOS Klinikum Wuppertal, University Hospital Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany.
Philipp-Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany ; Center for Clinical and Translational Research, HELIOS Klinikum Wuppertal, University Hospital Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany.
Open Cardiovasc Med J. 2015 Jun 26;9:91-5. doi: 10.2174/1874192401509010091. eCollection 2015.
Appropriate use of sedatives and analgesics is essential to keep critically ill patients comfortable and to prevent prolonged mechanical ventilation time and length of stay in ICU. Aim of this study was to analyse the long-term effect of an algorithm-based individual analgesic-sedative protocol on mechanical ventilation time and ICU length of stay in critically ill patients after sudden cardiac arrest due to ST-elevated myocardial infarction.
We examined a total of 109 patients before and after implementation of an algorithm-based sedation management. Our sedation protocol included individual defined sedation goals achieved by standardized sedation strategies. Mechanical ventilation time and ICU length of stay were analysed for three groups of patients: before and after the intervention and in the long-term follow-up.
We observed shorter median mechanical ventilation time and ICU length of stay in the interventional and longterm follow-up group compared to the standard-care group without statistical significance.
Our results demonstrate a long-term reduction of mechanical ventilation time and ICU length of stay achieved by implementation of an individual sedation management. This suggests sedation guidelines as effective tools to reduce the mechanical ventilation time and ICU length of stay in patients after sudden cardiac arrest in ST-elevated myocardial infarction. Investigations with a larger patient number and higher statistical power are required to confirm these findings.
合理使用镇静剂和镇痛药对于让重症患者保持舒适、防止机械通气时间延长和在重症监护病房（ICU）的住院时间过长至关重要。本研究的目的是分析基于算法的个体化镇痛镇静方案对因ST段抬高型心肌梗死导致的心搏骤停重症患者机械通气时间和ICU住院时间的长期影响。
我们在基于算法的镇静管理实施前后共检查了109例患者。我们的镇静方案包括通过标准化镇静策略实现个体化定义的镇静目标。对三组患者的机械通气时间和ICU住院时间进行了分析：干预前、干预后以及长期随访。
与标准治疗组相比，我们观察到干预组和长期随访组的机械通气时间中位数和ICU住院时间较短，但无统计学意义。
我们的结果表明，通过实施个体化镇静管理可长期减少机械通气时间和ICU住院时间。这表明镇静指南是减少ST段抬高型心肌梗死心搏骤停患者机械通气时间和ICU住院时间的有效工具。需要进行更大样本量和更高统计效能的研究来证实这些发现。
