Risk Factors of Delirium in Sequential Sedation Patients in Intensive Care Unit

Study Overview
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Brief Summary
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Delirium is one of main adverse events in ventilated patients who receive long-term usage of mono-sedative. Sequential sedation may reduce these adverse effects. This study aimed to evaluate incidence and risk factors for delirium in sequential sedation patients.

Detailed Description
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Previous studies have showed that patients under mechanical ventilation have a higher risk for experiencing delirium than nonmechanically ventilated patients (20%-50%). Its occurrence is also more frequent in elder patients. More than that, it is often hard to identify delirium by physicians, leading to unreasonable management of ICU patients. And delirium is one of main adverse events in ventilated patients who receive long-term usage of mono-sedative. Sequential sedation may reduce these adverse effects. However, few present studies focus on delirium in sequential sedation patients. Thus, in this study, we aimed to determine the factors of delirium in patients who received sequential sedation in ICU.

Official Title
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Risk Factors of Delirium in Sequential Sedation Patients in Intensive Care Unit

Conditions
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Delirium, Mechanical Ventilation, Sedation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Intubated patients; Age≥18 years old; Anticipated Ventilation and sedation duration of at least 72 hours. Exclusion Criteria: Allergy to the study drug; suspected pregnancy; gross obesity; Extremely unstable of circulatory system, such as systolic blood pressure less than 90 mm Hg despite plasma volume expansion and continuous infusions of vasopressors before the start of study drug infusion; Uncontrolled abnormal hypertension, such as systolic blood pressure more than 180 mmHg or diastolic more than105 mmHg; Heart rate less than 50 bpm; Second or third degree heart block; moribund state; history of alcoholism or intake of anti-anxiety drugs or hypnotics; chronic renal failure; coma by cranial trauma or neurosurgery or unknown etiology or epileptic state; History of neuromuscular disease; unwillingness to provide informed consent by patients or their authorized surrogates following ICU admission.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| delirium group<br> | |
| nondelirium group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delirium assessment in Sequential Sedation Patients | The primary outcome of this study was delirium. Patient evaluations were implemented using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale every four hours a day for a maximum of twenty-eight days or until ICU discharge, whichever occurred first. The risk factors were analyzed using risk regression (logistic-regression). Any variables which had P<0.2 after univariable logistic-regression or potential variables associated with delirium were included for multivariable logistic-regression. P<0.05 was considered to represent statistical significance. | A maximum of twenty-eight days or until ICU discharge, whichever occurred first. |