Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS
The coronavirus pandemic continues to challenge global healthcare. Severely affected patients are often in need of high doses of analgesics and sedatives. The latter was studied in critically ill coronavirus disease 2019 (COVID-19) patients in this prospective monocentric analysis. COVID-19 acute re...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/588 |
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| author | Armin N. Flinspach Hendrik Booke Kai Zacharowski Ümniye Balaban Eva Herrmann Elisabeth H. Adam |
| author_facet | Armin N. Flinspach Hendrik Booke Kai Zacharowski Ümniye Balaban Eva Herrmann Elisabeth H. Adam |
| author_sort | Armin N. Flinspach |
| collection | DOAJ |
| description | The coronavirus pandemic continues to challenge global healthcare. Severely affected patients are often in need of high doses of analgesics and sedatives. The latter was studied in critically ill coronavirus disease 2019 (COVID-19) patients in this prospective monocentric analysis. COVID-19 acute respiratory distress syndrome (ARDS) patients admitted between 1 April and 1 December 2020 were enrolled in the study. A statistical analysis of impeded sedation using mixed-effect linear regression models was performed. Overall, 114 patients were enrolled, requiring unusual high levels of sedatives. During 67.9% of the observation period, a combination of sedatives was required in addition to continuous analgesia. During ARDS therapy, 85.1% (<i>n</i> = 97) underwent prone positioning. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) was required in 20.2% (<i>n</i> = 23) of all patients. vv-ECMO patients showed significantly higher sedation needs (<i>p</i> < 0.001). Patients with hepatic (<i>p</i> = 0.01) or renal (<i>p</i> = 0.01) dysfunction showed significantly lower sedation requirements. Except for patient age (<i>p</i> = 0.01), we could not find any significant influence of pre-existing conditions. Age, vv-ECMO therapy and additional organ failure could be demonstrated as factors influencing sedation needs. Young patients and those receiving vv-ECMO usually require increased sedation for intensive care therapy. However, further studies are needed to elucidate the causes and mechanisms of impeded sedation. |
| first_indexed | 2024-03-09T23:41:44Z |
| format | Article |
| id | doaj.art-47d9409cce224d0bada8ea05cb987296 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:41:44Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-47d9409cce224d0bada8ea05cb9872962023-11-23T16:50:49ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111358810.3390/jcm11030588Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDSArmin N. Flinspach0Hendrik Booke1Kai Zacharowski2Ümniye Balaban3Eva Herrmann4Elisabeth H. Adam5Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyDepartment of Biostatistics and Mathematical Modelling, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyDepartment of Biostatistics and Mathematical Modelling, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Frankfurt, 60590 Frankfurt/Main, GermanyThe coronavirus pandemic continues to challenge global healthcare. Severely affected patients are often in need of high doses of analgesics and sedatives. The latter was studied in critically ill coronavirus disease 2019 (COVID-19) patients in this prospective monocentric analysis. COVID-19 acute respiratory distress syndrome (ARDS) patients admitted between 1 April and 1 December 2020 were enrolled in the study. A statistical analysis of impeded sedation using mixed-effect linear regression models was performed. Overall, 114 patients were enrolled, requiring unusual high levels of sedatives. During 67.9% of the observation period, a combination of sedatives was required in addition to continuous analgesia. During ARDS therapy, 85.1% (<i>n</i> = 97) underwent prone positioning. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) was required in 20.2% (<i>n</i> = 23) of all patients. vv-ECMO patients showed significantly higher sedation needs (<i>p</i> < 0.001). Patients with hepatic (<i>p</i> = 0.01) or renal (<i>p</i> = 0.01) dysfunction showed significantly lower sedation requirements. Except for patient age (<i>p</i> = 0.01), we could not find any significant influence of pre-existing conditions. Age, vv-ECMO therapy and additional organ failure could be demonstrated as factors influencing sedation needs. Young patients and those receiving vv-ECMO usually require increased sedation for intensive care therapy. However, further studies are needed to elucidate the causes and mechanisms of impeded sedation.https://www.mdpi.com/2077-0383/11/3/588critical carehypnotics and sedativesacute respiratory distress syndromesevere acute respiratory syndrome coronavirus 2pulmonary ventilationprone position |
| spellingShingle | Armin N. Flinspach Hendrik Booke Kai Zacharowski Ümniye Balaban Eva Herrmann Elisabeth H. Adam Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS Journal of Clinical Medicine critical care hypnotics and sedatives acute respiratory distress syndrome severe acute respiratory syndrome coronavirus 2 pulmonary ventilation prone position |
| title | Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS |
| title_full | Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS |
| title_fullStr | Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS |
| title_full_unstemmed | Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS |
| title_short | Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS |
| title_sort | associated factors of high sedative requirements within patients with moderate to severe covid 19 ards |
| topic | critical care hypnotics and sedatives acute respiratory distress syndrome severe acute respiratory syndrome coronavirus 2 pulmonary ventilation prone position |
| url | https://www.mdpi.com/2077-0383/11/3/588 |
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