tailieunhanh - Báo cáo y học: "A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety. | Jackson et al. Critical Care 2010 14 R59 http content 14 2 R59 c CRITICAL CARE RESEARCH Open Access A systematic review of the impact of sedation practice in the ICU on resource use costs and patient safety Daniel L Jackson 1 Clare W Proudfoot2 Kimberley F Cann2 and Tim Walsh3 Abstract Introduction Patients in intensive care units ICUs often receive sedation for prolonged periods. In order to better understand the impact of sub-optimal sedation practice on outcomes we performed a systematic review including observational studies and controlled trials which were conducted in sedated patients in the ICU and which compared the impact of changes in or different protocols for sedation management on economic and patient safety outcomes. Methods We searched Medline Embase and CINAHL online literature databases from 1988 to 15th May 2008 and hand searched conferences. English-language studies set in the ICU in sedated adult humans on mechanical ventilation which reported the impact of sedation practice on cost and resource use and patient safety outcomes were included. All abstracts were reviewed twice by two independent reviewers with all conflicts resolved by a third reviewer to check that they met the review inclusion criteria. Full-text papers of all included studies were retrieved and again reviewed twice against inclusion criteria. Data were doubly extracted from studies. Study aims design population and outcomes including duration of mechanical ventilation length of stay in ICU and hospital costs and rates of mortality and adverse events were extracted. Due to heterogeneity between study designs and outcomes reported no quantitative data synthesis such as meta-analysis was possible. Results Included studies varied in design patient population and aim with the majority being before-after studies. Overall studies showed that improvements in sedation practice such as the introduction of guidelines and protocols or daily interruption of sedation were .