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Patient outcomes among critically ill patients are significantly affected by occurrences of pain, agitation, and delirium (PAD). Opportunities for improvement in care include increasing delirium monitoring, performing SATs, and decreasing use of sedation, particularly benzodiazepines. ConclusionsĪnalgesia and sedation practices varied widely across international regions and significantly changed over time. Any delirium during admission increased from 7 to 8% of patients overall and doubled in the US/Canada region (17 to 36%, p < 0.001). Performance of SATs increased overall, driven mostly by the US/Canada region (24 to 35% of days with sedation, p < 0.001). Benzodiazepine use decreased in every region but remained the most common sedative in Africa, Asia, and Latin America. Proportion of days utilizing analgesia and sedation increased from 2010 to 2016 ( p < 0.001 for each). ResultsĪ total of 14,281 patients from 6 international regions were analyzed.
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#NON COHORT DATA ANALYSIS BEST PRACTICES TRIAL#
Proportion of days utilizing sedation, analgesia, and performance of a spontaneous awakening trial (SAT), and occurrence of delirium were described for each year and region and compared between years. Mechanically ventilated adults were followed for up to 28 days in 20. We performed a retrospective analysis of two multicenter, international, prospective cohort studies. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions. While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed.