An evaluation of patient-specific characteristics on attainment of target sedation in an intensive care unit.

BACKGROUND

Sedation of mechanically ventilated patients should optimize comfort and safety while avoiding over-sedation and adverse outcomes. To our knowledge, characteristics associated with attaining target sedation are unknown.

OBJECTIVES

Evaluate current sedation practice at a single center and explore which patient characteristics are associated with attaining target sedation.

METHODS

This is a single-center, retrospective chart review of sedated, ventilated patients in a medical/surgical ICU. Demographic and clinical data were collected. Univariate and multivariate logistic regression analyses were used with attaining target sedation as the dependent variable.

RESULTS

Of the 100 patients included (median 60.5 years), 50 attained target sedation. Univariate analyses (a = 0.10) revealed factors associated with target sedation were age (P = 0.08), history of alcohol abuse (P = 0.08), multiple comorbidities (P = 0.09), and delirium monitoring (P = 0.002). Multivariate analysis revealed an association between delirium monitoring/documentation and attaining target sedation (P = 0.005; OR 9.2; 95% CI 2.3-36.8).

CONCLUSIONS

Patients without appropriate delirium monitoring/documentation had significantly reduced likelihood of achieving target sedation.