Impact of Alcohol and Drug Use on Sedation and Ventilation
Author Information
Author(s): de Wit Marjolein, Wan Sau Yin, Gill Sujoy, Jenvey Wendy I, Best Al M, Tomlinson Judith, Weaver Michael F
Primary Institution: Virginia Commonwealth University
Hypothesis
Patients with alcohol and other drug use disorders (AOD) would require higher doses of sedatives and opioids, have more episodes of agitation, and require a longer duration of mechanical ventilation than those without AOD.
Conclusion
Patients with AOD receive higher doses of sedation than their non-AOD counterparts to achieve similar sedation levels but do not undergo longer duration of mechanical ventilation.
Supporting Evidence
- 39% of mechanically ventilated patients in the ICU had AOD.
- AOD patients received 2.5 times more sedatives and 5 times more opioids than non-AOD patients.
- Despite higher sedation doses, the duration of mechanical ventilation was similar between AOD and non-AOD patients.
Takeaway
Patients who use alcohol and drugs need more medicine to feel calm when on a breathing machine, but they don't stay on the machine longer than those who don't use these substances.
Methodology
Retrospective review of medical records of adult patients undergoing mechanical ventilation in the medical ICU.
Potential Biases
Clinicians may not routinely determine the presence of AOD, leading to potential underdiagnosis.
Limitations
The diagnosis of AOD is difficult to establish, and there may be underdiagnosis and misclassification of patients.
Participant Demographics
Of the 70 patients, 27 had AOD (39%), with a higher prevalence in males (21 men vs. 6 women).
Statistical Information
P-Value
p < 0.0001
Confidence Interval
[45.0; 55.8]
Statistical Significance
p < 0.0001
Digital Object Identifier (DOI)
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