Long-term Effect of Optimized Sedation and Pain Management after Sudden Cardiac Arrest



Nadine Abanador-Kamper 1, 4, *, Judith Wolfertz 1, 4, Petra Thürmann2, 4, Lars Kamper3, 4, Melchior Seyfarth1, 4
1 Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Arrenberger Straße 20, 42117 Wuppertal, Germany
2 Philipp-Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany
3 Department of Diagnostic and Interventional Radiology, HELIOS Clinic Wuppertal, University Hospital Witten/ Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany
4 Center for Clinical and Translational Research, HELIOS Klinikum Wuppertal, University Hospital Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany


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© Abanador-Kamper et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Cardiology and Center for Clinical and Translational Research Germany; E-mail: Nadine.Abanador@helios-kliniken.de


Abstract

Background and Aims:

Appropriate use of sedatives and analgesics is essential to keep critically ill patients comfortable and to prevent prolonged mechanical ventilation time and length of stay in ICU. Aim of this study was to analyse the long-term effect of an algorithm-based individual analgesic-sedative protocol on mechanical ventilation time and ICU length of stay in critically ill patients after sudden cardiac arrest due to ST-elevated myocardial infarction.

Subject and Methods:

We examined a total of 109 patients before and after implementation of an algorithm-based sedation management. Our sedation protocol included individual defined sedation goals achieved by standardized sedation strategies. Mechanical ventilation time and ICU length of stay were analysed for three groups of patients: before and after the intervention and in the long-term follow-up.

Results:

We observed shorter median mechanical ventilation time and ICU length of stay in the interventional and longterm follow-up group compared to the standard-care group without statistical significance.

Conclusion:

Our results demonstrate a long-term reduction of mechanical ventilation time and ICU length of stay achieved by implementation of an individual sedation management. This suggests sedation guidelines as effective tools to reduce the mechanical ventilation time and ICU length of stay in patients after sudden cardiac arrest in ST-elevated myocardial infarction. Investigations with a larger patient number and higher statistical power are required to confirm these findings.

Keywords: Sedation protocol, long-term effect, guideline, mechanical ventilation.