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使用里士满躁动镇静量表对重症监护病房住院患者住院时间、呼吸机依赖及死亡率的影响:一项随机临床试验

The effect of using Richmond agitation and sedation scale on hospital stay, ventilator dependence, and mortality rate in ICU inpatients: a randomised clinical trial.

作者信息

Rashidi Mahbobeh, Molavynejad Shahram, Javadi Nasser, Adineh Mohammad, Sharhani Assad, Poursangbur Tayebeh

机构信息

Assistant Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Assistant Professor, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Res Nurs. 2020 Dec;25(8):734-746. doi: 10.1177/1744987120943921. Epub 2020 Sep 3.

Abstract

BACKGROUND

Managing the amount of use of sedatives due to their high side effects in the intensive care unit is essential. Sedation-agitation protocols may play an important role in this regard. However, they have not been practically applied in Iran.

AIMS

This study aimed to evaluate the effect of using the Richmond agitation and sedation scale on hospital stay duration and dependency rate on the intensive care unit ventilator system in Ahwaz City, Iran, in 2016-2017.

METHODS

This randomised clinical trial was conducted on 74 patients. The subjects were selected by a stratified sampling method and divided into the experimental ( = 32) and control ( = 32) groups. Sedation and agitation levels were managed by the Richmond agitation and sedation scale as soon as the samples were anxious and agitated, and every 6 hours in the intervention group. However, the control group received routine care. The data obtained were analysed by the Statistical Package for the Social Sciences (SPSS).

RESULTS

There was no significant difference between the two groups in terms of demographic variables, such as age, gender, admission diagnosis and Glasgow coma scale scores on admission. However, they differed in terms of hospital stay duration and ventilator connection ( < 0.001), Glasgow coma scale score at the separation time from the device ( < 0.001), Glasgow coma scale score at the discharge time from the intensive care unit ( < 0.02) and intensive care unit death rate ( < 0.001). In all cases mentioned previously, the intervention group's condition was better.

CONCLUSIONS

Based on the results of this study, as well as the approval of validation and reliability of the Richmond agitation and sedation scale in different studies, this protocol can be very effective in optimising the use of sedatives in the intensive care unit.

摘要

背景

由于镇静剂在重症监护病房有较高的副作用,因此控制其使用量至关重要。镇静 - 躁动方案在这方面可能发挥重要作用。然而,它们在伊朗尚未得到实际应用。

目的

本研究旨在评估2016 - 2017年在伊朗阿瓦士市使用里士满躁动镇静量表对住院时间和重症监护病房呼吸机系统依赖率的影响。

方法

这项随机临床试验对74名患者进行。受试者通过分层抽样方法选取,并分为试验组(n = 32)和对照组(n = 32)。一旦样本出现焦虑和躁动,试验组即按照里士满躁动镇静量表管理镇静和躁动水平,且每6小时进行一次。然而,对照组接受常规护理。所获数据采用社会科学统计软件包(SPSS)进行分析。

结果

两组在年龄、性别、入院诊断和入院时格拉斯哥昏迷量表评分等人口统计学变量方面无显著差异。然而,在住院时间和呼吸机连接情况(P < 0.001)、与设备分离时的格拉斯哥昏迷量表评分(P < 0.001)、从重症监护病房出院时的格拉斯哥昏迷量表评分(P < 0.02)以及重症监护病房死亡率(P < 0.001)方面存在差异。在上述所有情况下,试验组情况更佳。

结论

基于本研究结果,以及不同研究对里士满躁动镇静量表有效性和可靠性的认可,该方案在优化重症监护病房镇静剂使用方面可能非常有效。

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Sedation and Analgesia for Mechanically Ventilated Patients in the Emergency Department.急诊科机械通气患者的镇静与镇痛
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