<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2021-0026_s_006">
<h3>Background</h3>
<p>The 2018 Society of Critical Care Medicine guidelines on the “Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU” advocate for protocol-based analgosedation practices. There are limited data available to guide which analgesic to use. This study compares outcomes in patients who received continuous infusions of fentanyl or hydromorphone as sedative agents in the intensive care setting.</p>
</sec>
<sec id="j_jccm-2021-0026_s_007">
<h3>Methods</h3>
<p>This retrospective cohort study evaluated patients admitted into the medical intensive care unit, the surgical intensive care unit, and the cardiac intensive care unit from April 1, 2017, to August 1, 2018, who were placed on continuous analgesics. Patients were divided according to receipt of fentanyl or hydromorphone as a continuous infusion as a sedative agent. The primary endpoints were ICU length of stay and time on mechanical ventilation.</p>
</sec>
<sec id="j_jccm-2021-0026_s_008">
<h3>Results</h3>
<p>A total of 177 patients were included in the study; 103 received fentanyl as a continuous infusion, and 74 received hydromorphone as a continuous infusion. Baseline characteristics were similar between groups. Patients in the hydromorphone group had deeper sedation targets. Median ICU length of stay was eight days in the fentanyl group compared to seven days in the hydromorphone group (p = 0.11) and median time on mechanical ventilation was 146.47 hours in the fentanyl group and 122.33 hours in the hydromorphone group (p = 0.31). There were no statistically significant differences in the primary endpoints of ICU length of stay and time on mechanical ventilation between fentanyl and hydromorphone for analgosedation purposes.</p>
</sec>
<sec id="j_jccm-2021-0026_s_009">
<h3>Conclusion</h3>
<p>No statistically significant differences were found in the primary endpoints studied. Patients in the hydromorphone group required more tracheostomies, restraints, and were more likely to have a higher proportion of Critical Care Pain Observation Tool (CPOT) scores > 2.</p>
</sec>
</abstract>

Background
The 2018 Society of Critical Care Medicine guidelines on the “Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU” advocate for protocol-based analgosedation practices. There are limited data available to guide which analgesic to use. This study compares outcomes in patients who received continuous infusions of fentanyl or hydromorphone as sedative agents in the intensive care setting.


Methods
This retrospective cohort study evaluated patients admitted into the medical intensive care unit, the surgical intensive care unit, and the cardiac intensive care unit from April 1, 2017, to August 1, 2018, who were placed on continuous analgesics. Patients were divided according to receipt of fentanyl or hydromorphone as a continuous infusion as a sedative agent. The primary endpoints were ICU length of stay and time on mechanical ventilation.


Results
A total of 177 patients were included in the study; 103 received fentanyl as a continuous infusion, and 74 received hydromorphone as a continuous infusion. Baseline characteristics were similar between groups. Patients in the hydromorphone group had deeper sedation targets. Median ICU length of stay was eight days in the fentanyl group compared to seven days in the hydromorphone group (p = 0.11) and median time on mechanical ventilation was 146.47 hours in the fentanyl group and 122.33 hours in the hydromorphone group (p = 0.31). There were no statistically significant differences in the primary endpoints of ICU length of stay and time on mechanical ventilation between fentanyl and hydromorphone for analgosedation purposes.


Conclusion
No statistically significant differences were found in the primary endpoints studied. Patients in the hydromorphone group required more tracheostomies, restraints, and were more likely to have a higher proportion of Critical Care Pain Observation Tool (CPOT) scores > 2.

Analgosedation: The use of Fentanyl Compared to Hydromorphone

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

{"article-title":"Analgosedation: The use of Fentanyl Compared to Hydromorphone"}

Background
The 2018 Society of Critical Care Medicine guidelines on the “Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep...

Analgosedation: The use of Fentanyl Compared to Hydromorphone

Article Category: Research Article

Publicado en línea: 05 ago 2021

Páginas: 192 - 198

Recibido: 05 jul 2020

Aceptado: 06 jul 2021

DOI: https://doi.org/10.2478/jccm-2021-0026

Palabras clave
analgosedation, sedation, analgesic, pain, agitation

© 2021 Hahnl Choi, Sara Radparvar, Samuel L. Aitken, Jerry Altshuler, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Analgosedation: The use of Fentanyl Compared to Hydromorphone

Article Category: Research Article

Publicado en línea: 05 ago 2021

Páginas: 192 - 198

Recibido: 05 jul 2020

Aceptado: 06 jul 2021

DOI: https://doi.org/10.2478/jccm-2021-0026

Palabras claveanalgosedation, sedation, analgesic, pain, agitation

© 2021 Hahnl Choi, Sara Radparvar, Samuel L. Aitken, Jerry Altshuler, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Palabras clave
analgosedation, sedation, analgesic, pain, agitation