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| fixed length control field |
03787nam a22007217a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
190827s20192019 xxu||||| |||| 00| 0 eng d |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| Classification number |
31393323 |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0090-3493 |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
10.1097/CCM.0000000000003928 [doi] |
| 190 ## - |
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Fuller BM |
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Roberts BW |
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Mohr NM |
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Knight WA 4th |
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Adeoye O |
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Pappal RD |
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Marshall S |
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Alunday R |
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Dettmer M |
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Goyal M |
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Gibson C |
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Levine BJ |
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Gardner-Gray JM |
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Mosier J |
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Dargin J |
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Mackay F |
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Johnson NJ |
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Lokhandwala S |
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Hough CL |
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Tonna JE |
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Tsolinas R |
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Lin F |
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Qasim ZA |
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Harvey CE |
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Bassin B |
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Stephens RJ |
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Yan Y |
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Carpenter CR |
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Kollef MH |
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Avidan MS |
| 100 ## - MAIN ENTRY--PERSONAL NAME |
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| Personal name |
Goyal, Munish |
| 245 ## - TITLE STATEMENT |
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| Title |
The ED-SED Study: A Multicenter, Prospective Cohort Study of Practice Patterns and Clinical Outcomes Associated With Emergency Department SEDation for Mechanically Ventilated Patients. |
| 251 ## - |
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Critical Care Medicine. 2019 Aug 07 |
| 252 ## - |
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Crit Care Med. 2019 Aug 07 |
| 253 ## - |
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Critical care medicine |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| -- |
aheadofprint |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Date of publication, distribution, etc. |
2019 |
| 269 ## - |
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FY2020 |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
OBJECTIVES: To characterize emergency department sedation practices in mechanically ventilated patients, and test the hypothesis that deep sedation in the emergency department is associated with worse outcomes. |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
DESIGN: Multicenter, prospective cohort study. |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
SETTING: The emergency department and ICUs of 15 medical centers. |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
PATIENTS: Mechanically ventilated adult emergency department patients. |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
INTERVENTIONS: None. |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
MEASUREMENTS AND MAIN RESULTS: All data involving sedation (medications, monitoring) were recorded. Deep sedation was defined as Richmond Agitation-Sedation Scale of -3 to -5 or Sedation-Agitation Scale of 2 or 1. A total of 324 patients were studied. Emergency department deep sedation was observed in 171 patients (52.8%), and was associated with a higher frequency of deep sedation in the ICU on day 1 (53.8% vs 20.3%; p < 0.001) and day 2 (33.3% vs 16.9%; p = 0.001), when compared to light sedation. Mean (SD) ventilator-free days were 18.1 (10.8) in the emergency department deep sedation group compared to 20.0 (9.8) in the light sedation group (mean difference, 1.9; 95% CI, -0.40 to 4.13). Similar results according to emergency department sedation depth existed for ICU-free days (mean difference, 1.6; 95% CI, -0.54 to 3.83) and hospital-free days (mean difference, 2.3; 95% CI, 0.26-4.32). Mortality was 21.1% in the deep sedation group and 17.0% in the light sedation group (between-group difference, 4.1%; odds ratio, 1.30; 0.74-2.28). The occurrence rate of acute brain dysfunction (delirium and coma) was 68.4% in the deep sedation group and 55.6% in the light sedation group (between-group difference, 12.8%; odds ratio, 1.73; 1.10-2.73). |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
CONCLUSIONS: Early deep sedation in the emergency department is common, carries over into the ICU, and may be associated with worse outcomes. Sedation practice in the emergency department and its association with clinical outcomes is in need of further investigation. |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
IN PROCESS -- NOT YET INDEXED |
| 656 ## - INDEX TERM--OCCUPATION |
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| Occupation |
Emergency Medicine |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Geographic name |
MedStar Washington Hospital Center |
| 657 ## - INDEX TERM--FUNCTION |
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| Function |
Journal Article |
| 857 ## - |
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| -- |
https://dx.doi.org/10.1097/CCM.0000000000003928 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
