Effect of using Richmond Agitation Sedation Scale on duration of mechanical ventilation, type and dosage of sedation on hospitalized patients in intensive care units.
Effect of using Richmond Agitation Sedation Scale on duration of mechanical ventilation, type and dosage of sedation on hospitalized patients in intensive care units.
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DOI：
10.4103/1735-9066.170008
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发表时间：
2015-11
影响因子：
1.1
通讯作者：
Fazel K
中科院分区：
文献类型：
--
作者：
Yousefi H;Toghyani F;Yazdannik AR;Fazel K
机械通气是用于不同原因的支持治疗之一。为减少患者因使用气管插管和呼吸机而造成的不便，常规使用镇静剂。使用镇静量表，例如，里士满躁动镇静量表（RASS），可以减少镇静剂量和机械通气时间。本研究是一项随机临床试验，入选了来自伊朗伊斯法罕3个重症监护室（ICU）的64例患者。通过随机分配，32例患者被分配到研究组和对照组。对照组按医嘱记录患者意识水平及每班用药量。研究组每小时记录一次RASS评分，并据此给予镇静。本研究的目的是研究RASS在药物消耗中的应用，直至患者脱离呼吸机。使用显著性水平为0.05的独立t检验。结果显示，干预后咪达唑仑和吗啡的平均消耗量无显著差异，但干预后组间芬太尼的消耗量（对照组为379 μg，研究组为75 μg）有显著差异（P = 0.03）。研究组连接到呼吸机的平均持续时间显著更短（P = 0.03）。护士应用RASS可减少镇静消耗、呼吸机连接和住院时间。
Mechanical ventilation is one of the supporting treatments that are used for different reasons. To reduce patients’ inconvenience caused due to using tracheal tube and ventilator, sedation is routinely used. Using scales for the sedation, for example, Richmond Agitation Sedation Scale (RASS), may reduce dose of sedation and length of mechanical ventilation. This study is a randomized clinical trial on 64 patients selected from three intensive care units (ICUs) in Isfahan, Iran. Through random allocation, 32 patients were assigned to each of the study and control groups. In the control group, patients’ level of consciousness and the amount of drug consumption in every shift, based on physician order, were recorded. In the study group, RASS score was recorded every hour and sedation was administered based on that. The purpose of the study was to investigate of application of RASS for drug consumption until weaning of the patient from the ventilator. Independent t-test with significance level of 0.05 was used. Results showed no significant difference in the mean consumption of midazolam and morphine after intervention, but there was a significant difference in fentanyl (P = 0.03) consumption (379 μg in the control group vs 75 μg in the study group) between groups after the intervention. The mean duration of being connected to the ventilator was significantly less in the study group (P = 0.03). Application of RASS by nurses leads to a decrease in sedation consumption, connection to ventilator, and length of stay in the hospital.