Abstract
Abstract
Introduction
The purpose of this study was to evaluate the effect of substance use on sedation requirements in critically ill patients to optimize dosing in this population.
Methods
This was a multicenter, retrospective, observational, institutional review board–approved, cohort study. Included individuals were aged 18 years and older, required mechanical ventilation for more than 24 hours, and had a history of substance use in the intervention group, defined as documentation of using 1 or more substances within the past year. The primary outcome was the maximum number of concurrent continuous analgesic and sedative infusions required during intubation and mechanical ventilation.
Results
The primary outcome, maximum number of concurrent continuous analgesic and sedative infusions, was significantly higher when comparing subjects with substance use to those without substance use (3 vs 2 infusions;
P
P
= 0.024), dexmedetomidine (1.2 vs 1.0 mcg/kg/hr;
P
= 0.040), and benzodiazepines measured in lorazepam equivalents (3 vs 1.5 mg/hr;
P
Conclusion
In mechanically ventilated subjects, a statistically significantly higher number of concurrent continuous analgesic and sedative infusions were used in the substance use group, with larger doses required to sedate subjects.