Implementing pain, agitation, delirium, and sleep deprivation protocol in critically ill patients : A pilot study on pharmacological interventions
© 2024 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics..
Critically ill patients frequently experience pain, agitation, delirium, and sleep deprivation, which have been linked to increased mortality and unfavorable clinical outcomes. To address these challenges, the Pain, Agitation, Delirium, and Sleep Deprivation (PADS) protocol was developed, aiming to mitigate mortality and improve clinical outcomes. This study focuses on assessing the protocol's impact using a robust before-and-after study design in the medical and surgical intensive care units (ICUs) at Ramathibodi Hospital. Using an observational approach, this study compares clinical outcomes before and after implementing the PADS protocol in the ICUs. Two patient cohorts were identified: the "before" group, comprising 254 patients with retrospective data collected between May 2018 and September 2019, and the "after" group, consisting of 255 patients for whom prospective data was collected from May to September 2020. Analysis reveals improvements in the after group. Specifically, there was a significant increase in 14-day ICU-free days (9.95 days vs. 10.40 days, p value = 0.014), a decrease in delirium incidence (18.1% vs. 16.1%, p value < 0.001), and a significant reduction in benzodiazepine usage (38.6% vs. 24.6%, p value = 0.001) within the after group. This study emphasizes the protocol's potential to improve patient care and highlights its significance in the ICU context.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
|---|---|
| Enthalten in: |
Clinical and translational science - 17(2024), 3 vom: 24. März, Seite e13739 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Luetrakool, Punchika [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 01.03.2024 Date Revised 17.04.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1111/cts.13739 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369111613 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369111613 | ||
| 003 | DE-627 | ||
| 005 | 20240418232645.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240301s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/cts.13739 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1379.xml |
| 035 | |a (DE-627)NLM369111613 | ||
| 035 | |a (NLM)38421247 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Luetrakool, Punchika |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Implementing pain, agitation, delirium, and sleep deprivation protocol in critically ill patients |b A pilot study on pharmacological interventions |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.03.2024 | ||
| 500 | |a Date Revised 17.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics. | ||
| 520 | |a Critically ill patients frequently experience pain, agitation, delirium, and sleep deprivation, which have been linked to increased mortality and unfavorable clinical outcomes. To address these challenges, the Pain, Agitation, Delirium, and Sleep Deprivation (PADS) protocol was developed, aiming to mitigate mortality and improve clinical outcomes. This study focuses on assessing the protocol's impact using a robust before-and-after study design in the medical and surgical intensive care units (ICUs) at Ramathibodi Hospital. Using an observational approach, this study compares clinical outcomes before and after implementing the PADS protocol in the ICUs. Two patient cohorts were identified: the "before" group, comprising 254 patients with retrospective data collected between May 2018 and September 2019, and the "after" group, consisting of 255 patients for whom prospective data was collected from May to September 2020. Analysis reveals improvements in the after group. Specifically, there was a significant increase in 14-day ICU-free days (9.95 days vs. 10.40 days, p value = 0.014), a decrease in delirium incidence (18.1% vs. 16.1%, p value < 0.001), and a significant reduction in benzodiazepine usage (38.6% vs. 24.6%, p value = 0.001) within the after group. This study emphasizes the protocol's potential to improve patient care and highlights its significance in the ICU context | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Taesotikul, Suthinee |e verfasserin |4 aut | |
| 700 | 1 | |a Susantitapong, Kanyarat |e verfasserin |4 aut | |
| 700 | 1 | |a Suthisisang, Chuthamanee |e verfasserin |4 aut | |
| 700 | 1 | |a Morakul, Sunthiti |e verfasserin |4 aut | |
| 700 | 1 | |a Sutherasan, Yuda |e verfasserin |4 aut | |
| 700 | 1 | |a Tangsujaritvijit, Viratch |e verfasserin |4 aut | |
| 700 | 1 | |a Dilokpattanamongkol, Pitchaya |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical and translational science |d 2008 |g 17(2024), 3 vom: 24. März, Seite e13739 |w (DE-627)NLM186388268 |x 1752-8062 |7 nnns |
| 773 | 1 | 8 | |g volume:17 |g year:2024 |g number:3 |g day:24 |g month:03 |g pages:e13739 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/cts.13739 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 17 |j 2024 |e 3 |b 24 |c 03 |h e13739 | ||