SAFETY AND ACCEPTABILITY OF PATIENT-ADMINISTERED SEDATIVES DURING MECHANICAL VENTILATION.
Background Safety and acceptability of sedative selfadministration by patients receiving mechanical ventilation is unknown. Objectives To determine if self-administration of dexmedetomidine by patients is safe and acceptable for selfmanagement of anxiety during ventilatory support. Methods In a pilo...
| Published in: | American Journal of Critical Care Vol. 26; no. 4; pp. 288 - 297 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts randomized controlled trial Journal Article |
| Published: |
American Association of Critical-Care Nurses
Jul2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123660857&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123660857 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: Jul2017 vid: 26 iid: 4 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 123660857 123660857 123660857 10.4037/ajcc2017408 123660857 ppf: 288 ppct: 9 formats: fmt: @attributes: type: P tig: atl: SAFETY AND ACCEPTABILITY OF PATIENT-ADMINISTERED SEDATIVES DURING MECHANICAL VENTILATION. aug: au: Chlan, Linda L. Skaar, Debra J. Tracy, Mary F. Hayes, Sarah M. Hetland, Breanna D. Savik, Kay Weinert, Craig R. affil: Associate dean for nursing research, Mayo Clinic, Rochester, Minnesota sug: subj: Patient Safety Ventilator Patients Psychosocial Factors Hypnotics and Sedatives Administration and Dosage Self Administration Infusion Pumps Anxiety Prevention and Control Critical Care Nursing Human Pilot Studies Intensive Care Units Heart Rate Evaluation Blood Pressure Determination APACHE (Acute Physiology and Chronic Health Evaluation) Severity of Illness Indices Anxiety Evaluation Multicenter Studies Protocols Utilization Random Assignment Randomized Controlled Trials Descriptive Statistics Adult Middle Age Aged Male Female T-Tests Mann-Whitney U Test Chi Square Test Professional Compliance Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background Safety and acceptability of sedative selfadministration by patients receiving mechanical ventilation is unknown. Objectives To determine if self-administration of dexmedetomidine by patients is safe and acceptable for selfmanagement of anxiety during ventilatory support. Methods In a pilot trial in 3 intensive care units, 17 intubated patients were randomly assigned to dex medetomidine and 20 to usual care. Dexmede tomidine was administered via standard pumps for patient- controlled analgesia, with a basal infusion (0.1-0.7 µg/kg per hour) titrated by the number of patient-triggered doses (0.25 µg/kg per dose). Safety goals were heart rate greater than 40/min, systolic blood pressure greater than 80 mm Hg, and diastolic blood pressure greater than 50 mm Hg. Acceptability was based on patients' self-reported satisfaction and ability to administer the sedative. A 100-mm visual analog scale was used daily to assess patients' anxiety. Results The sample was 59% male and 89% white. Mean values were age, 50.6 years; score on the Acute Physiology and Chronic Health Evaluation, 60.1; and protocol duration, 3.4 days. Five dexmedetomidine patients had blood pressure and/or heart rate lower than safety parameters, necessitating short-term treatment. Nurses' adherence to reporting of safety parameters was 100%; adherence to the dexmedetomidine titration algorithm was 73%. Overall baseline anxiety score was 38.4 and did not change significantly (βday = 2.1; SE, 2.5; P = .40). Most dexmedetomidine patients (92%) were satisfied or very satisfied with their ability to self-administer medication. Conclusions For select patients, self-administration of dexmedetomidine is safe and acceptable. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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