García-Sánchez M, Caballero-López J, Ceniceros-Rozalén I, Giménez-Esparza Vich C, Romera-Ortega M A, Pardo-Rey C, Muñoz-Martínez T, Escudero D, Torrado H, Chamorro-Jambrina C, Palencia-Herrejón E
Hospital Virgen Macarena, Sevilla, España.
Hospital Arnau de Vilanova, IRBLleida, Departament de Medicina, Universitat Autònoma de Barcelona, Lérida, España.
Med Intensiva (Engl Ed). 2019 May;43(4):225-233. doi: 10.1016/j.medin.2018.12.003. Epub 2019 Jan 28.
To know the real clinical practice of Spanish ICUs in relation to analgesia, sedation and delirium, with a view to assessing adherence to current recommendations.
A descriptive cross-sectional study was carried out based on a national survey on analgesia, sedation and delirium practices in patients admitted to intensive care on 16 November, 2013 and 16 October, 2014. An on-line questionnaire was sent with the endorsement of the SEMICYUC.
Spanish ICUs in public and private hospitals.
A total of 166 ICUs participated, with the inclusion of 1567 patients. The results showed that 61.4% of the ICUs had a sedation protocol, and 75% regularly monitored sedation and agitation - the RASS being the most frequently used scale. Pain was monitored in about half of the ICUs, but the behavioral scales were very little used. Delirium monitoring was implemented in few ICUs. Among the patients on mechanical ventilation, midazolam remained a very commonly used agent.
This survey is the first conducted in Spain on the practices of analgesia, sedation and delirium. We identified specific targets for quality improvement, particularly concerning the management of sedation and the assessment of delirium.
了解西班牙重症监护病房（ICU）在镇痛、镇静和谵妄方面的实际临床实践，以评估对当前建议的依从性。
基于2013年11月16日和2014年10月16日对入住重症监护病房患者的镇痛、镇静和谵妄实践进行的全国性调查，开展了一项描述性横断面研究。在西班牙重症监护与冠心病急救学会（SEMICYUC）的认可下，发送了一份在线问卷。
公立和私立医院的西班牙ICU。
共有166个ICU参与，纳入1567例患者。结果显示，61.4%的ICU有镇静方案，75%定期监测镇静和躁动——RASS是最常用的量表。约一半的ICU监测疼痛，但很少使用行为量表。很少有ICU实施谵妄监测。在机械通气患者中，咪达唑仑仍然是一种非常常用的药物。
这项调查是西班牙首次针对镇痛、镇静和谵妄实践开展的。我们确定了质量改进的具体目标，特别是在镇静管理和谵妄评估方面。
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