ICU sedation, delirium & recovery
Clinical Impact of the Implementation Strategies Used to Apply the 2013 Pain, Agitation/Sedation, Delirium or 2018 Pain, Agitation/Sedation, Delirium, Immobility, Sleep Disruption Guideline Recommendations: A Systematic Review and Meta-Analysis
Authors' conclusion
Using multiple implementation strategies to adopt PAD/PADIS guideline recommendations may reduce mortality, duration of MV, and ICU LOS.
Study context
- Population
- Adult ICU patients
- Participants
- 23,215 patients · 25 studies
- Comparison
- Effective Practice and Organization of Care (EPOC) strategies vs No EPOC strategies
- Outcome
- Clinical outcomes, cohort studies
Methodological detailsGRADE certainty assessment, cohort and randomised studies pooled separately, Risk of bias high in 13 (52%) studies
- GRADE certainty assessment
- Cohort and randomised studies pooled separately
- Risk of bias high in 13 (52%) studies
Pooled result
As reported in the abstract
EPOC strategies vs No EPOC strategiesRelative risk (95% CI)
Mortality
1.01(0.9–1.12)
Delirium
0.92(0.82–1.03)
EPOC strategies vs No EPOC strategiesWMD, d (95% CI)
MV duration
−0.84(−1.25 to −0.43)
ICU LOS
−0.77(−1.51 to 0.04)
Further pooled results
- Number of EPOC strategies used
- 5 · median · IQR 4–7
- Number of EPOC strategies used: to implement recommendations from two (IQR 2-3) Pain, Agitation/Sedation, Delirium (PAD)/PADIS domains
Clinical outcomes, randomised studies
- EPOC strategy use associated with reduced mortality and mechanical ventilation (MV) duration but not delirium or ICU length of stay (LOS)
Original publication
Clinical Impact of the Implementation Strategies Used to Apply the 2013 Pain, Agitation/Sedation, Delirium or 2018 Pain, Agitation/Sedation, Delirium, Immobility, Sleep Disruption Guideline Recommendations: A Systematic Review and Meta-Analysis. Crit Care Med. Published 9 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →