O artykule
Article Category: Research Article
Data publikacji: 05 sie 2021
Zakres stron: 192 - 198
Otrzymano: 05 lip 2020
Przyjęty: 06 lip 2021
DOI: https://doi.org/10.2478/jccm-2021-0026
Słowa kluczowe
© 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.
Primary Outcomes
| Fentanyl (n = 103) | Hydromorphone (n = 74) | p value | |
|---|---|---|---|
| ICU Length of Stay (days)a | 8 (4 - 15) | 7 (5 - 11) | 0.11 |
| Time on Mechanical Ventilation (hours)a | 146.47 (64.55 - 279.69) | 122.33 (70.27 - 204.98) | 0.31 |
Baseline Characteristics and Demographics
| Fentanyl (n = 103) | Hydromorphone (n = 74) | p value | |
|---|---|---|---|
| Age (years)a | 63 (53 - 70) | 61.5 (50 - 71) | 0.54 |
| APACHE IIa | 23 (17 - 29) | 25 (19 - 29) | 0.36 |
| Locationb | |||
| MICU | 52 (50.49) | 31 (41.89) | 0.47 |
| SICU | 39 (37.86) | 35 (47.30) | |
| CICU | 12 (11.65) | 8 (10.81) | |
| Admission Diagnosisb | |||
| Sepsis | 24 (23.3) | 13 (17.57) | |
| Respiratory | 21 (20.39) | 23 (31.08) | |
| GI | 35 (33.98) | 23 (31.08) | 0.20 |
| Metabolic | 1 (0.97) | 1 (1.35) | |
| Hematologic | 4 (3.88) | 0 (0.00) | |
| Cardiovascular | 15 (14.56) | 8 (10.81) | |
| Other | 3 (2.91) | 6 (8.11) | |
| % Maleb | 67 (65.05) | 40 (54.05) | 0.16 |
| Weight (kg)a | 78.20 (62.10 - 105) | 70.55 (60.40 - 85) | 0.17 |
| Race | |||
| White | 42 (40.78) | 24 (32.43) | |
| Black | 28 (27.18) | 13 (17.57) | 0.12 |
| Hispanic | 23 (22.33) | 21 (28.38) | |
| Asian | 6 (5.83) | 9 (12.16) | |
| Other/ Unknown | 4 (3.88) | 7 (9.46) | |
| Comorbidities | |||
| Pulmonary conditions | 32 (31.07) | 22 (29.73) | 0.87 |
| Hypertension | 57 (55.34) | 42 (56.76) | 0.88 |
| Diabetes | 41 (39.81) | 32 (43.24) | 0.76 |
| Coronary artery disease | 51 (49.51) | 25 (33.78) | 0.046* |
| Chronic Opioid Useb | 40 (38.83) | 38 (51.35) | 0.13 |
| Child Pughb | |||
| Class A | 18 (17.48) | 8 (10.81) | 0.28 |
| Class B or C | 85 (82.52) | 66 (89.19) | |
| Alcohol Withdrawal | 7 (6.8) | 1 (1.35) | 0.87 |
| RASS Goals | |||
| 0 to -2 | 97 (96.04) | 60 (82.19) | |
| -2 to -3 | 1 (0.99) | 5 (6.85) | 0.01* |
| -3 to -4 | 2 (1.98) | 3 (4.11) | |
| -4 to -5 | 1 (0.99) | 5 (6.85) | |
| Paralysis | 11 (10.68) | 19 (25.68) | 0.014* |
Background Sedative Use and Doses
| Fentanyl (n = 103) | Hydromorphone (n = 74) | p value | |
|---|---|---|---|
| Midazolam | 47 (45.63) | 30 (40.54) | 0.54 |
| Propofolb | 53 (51.46) | 42 (56.76) | 0.54 |
| Dexmedetomidine | 43 (41.75) | 18 (24.32) | 0.02* |
| Propofol (mg/kg/day)a | 16.17 (5.035 - 33.415) | 13.52 (7.205 - 27.08) | 0.67 |
| Midazolam (mg/day)a | 33.06 (16.3375 - 44.6275) | 22.76 (13.375 - 52.755) | 0.43 |
| Dexmedetomidine (mcg/kg/day)a | 7.24 (2.51 - 11.42) | 5.10 (1.79 - 8.97) | 0.37 |
Secondary Outcomes
| Fentanyl (n = 76) | Hydromorphone (n = 47) | p value | |
|---|---|---|---|
| CPOT>2, (% of time)a | 0 (0 – 0) | 1.23 (0 – 5.56) | <0.001* |
| CAM-ICU Positive, (% of time)a | 0 (0 – 7.14) | 0 (0 – 19.64) | 0.82 |
| Time Within Sedation Goal, (% of time)a | 63.16 (29.27 - 87.37) | 79.69 (35.38 - 88.42) | 0.43 |
| Self-Extubationb | 6 (5.83) | 9 (12.16) | 0.17 |
| Need for Restraintsb | 28 (27.18) | 33 (44.59) | 0.02* |
| Tracheostomyb | 8 (7.77) | 15 (20.27) | 0.02* |
| Constipationb | 40 (38.83) | 38 (51.35) | 0.13 |