The purpose of this study is to determine whether the use of different sedatives affect the weaning process from mechanical ventilation in intensive care patients.
Traditionally patients with ongoing mechanical ventilation have been sedated to assure absence of pain, anxiety and to provide comfort. Unfortunately this approach might have negative consequences such as prolonged time for mechanical ventilation, length of stay in the ICU and hospital. In this study, the investigators would like to investigate (in an exploratory way due to the non-interventional setup) whether weaning from mechanical ventilation will be affected by the choice of sedatives - including dexmedetomidine, midazolam and propofol. This study also aims at investigating how the choice of primary sedative will affect delirium/anxiety, need of other medications (sedatives, analgesics, anti-psychotics), quality of life after ICU and the presence of Post-Traumatic Stress Disorder. In addition, the investigators aim at receiving information from the caregivers on their ICU experience, as recent data imply that not only the ICU patient but also the caregiver suffer from PTSD after the ICU stay.
Study Type
OBSERVATIONAL
Enrollment
155
Patient are given standard of care
Danderyds Hospital Anestesi- och intensivvårdskliniken
Danderyd, Sweden
Örebro University Hospital, Anestesi- och intensivvårdskliniken
Örebro, Sweden
Capio S:t Goran Hospital, Anestesikliniken
Stockholm, Sweden
The time point from when the patient is considered "fit for weaning" to the actual time point for extubation
Time frame: 30 days
Time-point for patient being considered "fit for extubation"
Time frame: 30 days
Total time in mechanical ventilation
Time frame: 30 days
Extubation failure (re-intubation within 24 hours)
Time frame: 24 hours
Anxiety/delirium assessments
RASS/MAAS sedation scales and ICDSC/CAM-ICU delirium assessments methods are used, as appropriate
Time frame: 30 days
Length of ICU stay (actual time of discharge)
Time frame: 30 days
QoL (15D)
Time frame: 2-4 months post-ICU discharge
Post-Traumatic Stress Disorder assessment - PTSS14 questionnaire
This assessment will be offered to the ICU patients but also to their caregivers.
Time frame: 2-4 months post-ICU discharge
Total duration of sedation
Time frame: 30 days
Number of days using opioids
Time frame: 30 days
Number of days using antipsychotic/neuroleptic drugs
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Time frame: 30 days