Variable | No protocol | CPOE protocol | Revised CPOE protocol | P-value | P-value | P-value |
---|---|---|---|---|---|---|
(Mean ± SD) | (n = 91) | (n = 97) | (n = 91) | 1 vs. 2 | 2 vs. 3 | 1 vs. 3 |
Primary outcomes | ||||||
Mechanical ventilation duration, mean ± SD, days | 10 ± 9 | 12 ± 11 | 10 ± 8 | 0.21 | 0.2 | 0.98 |
ICU LOS, mean ± SD, days | 12 ± 10 | 13 ± 12 | 13 ± 11 | 0.78 | 0.91 | 0.69 |
Hospital LOS, mean ± SD, days | 63 ± 85 | 40 ± 37 | 46 ± 42 | 0.02 | 0.32 | 0.09 |
ICU mortality, n (%) | 24 (26) | 38 (39) | 16 (18) | 0.06 | 0.001 | 0.15 |
Hospital mortality, n (%) | 36 (40) | 43 (44) | 29 (32) | 0.51 | 0.08 | 0.28 |
Secondary outcomes | ||||||
Average daily doses of analgesics and sedatives | ||||||
Fentanyl, mcg/day | 2647 ± 2212 | 3720 ± 3286 | 2208 ± 2115 | 0.009 | 0.0002 | 0.17 |
Morphine, mg/day | 0.71 ± 4.88 | 0.36 ± 2.11 | 0.45 ± 2.18 | 0.54 | 0.79 | 0.64 |
Dexmedetomidine, mcg/day | 47.6 ± 113.7 | 48.3 ± 153.5 | 40.6 ± 124.1 | 0.97 | 0.71 | 0.69 |
Midazolam, mg/day | 84 ± 107 | 78 ± 101 | 68 ± 96 | 0.71 | 0.48 | 0.3 |
Propofol, mg/day | 271 ± 650 | 274 ± 833 | 509 ± 961 | 0.97 | 0.07 | 0.052 |
Lorazepam, mg/day | 0.09 ± 0.32 | 0.06 ± 0.26 | 0 ± 0 | 0.47 | 0.04 | 0.01 |
Haloperidol, mg/day | 0.27 ± 0.87 | 0.42 ± 1.77 | 0.23 ± 0.85 | 0.45 | 0.34 | 0.72 |
Paralytics, mg/day | 28 ± 61 | 20 ± 60 | 21 ± 49 | 0.34 | 0.84 | 0.41 |
Average NRS, SAS and GCS scores | ||||||
NRS score, mean ± SD | 0.24 ± 0.5 | 0.16 ± 0.36 | 1.02 ± 0.73 | 0.20 | <0.0001 | <0.0001 |
SAS score, mean ± SD | 2.5 ± 1.1 | 2.3 ± 1.1 | 2.5 ± 1.2 | 0.47 | 0.25 | 0.66 |
GCS score, mean ± SD | 6.8 ± 3.2 | 6.6 ± 3.2 | 6.9 ± 2.9 | 0.84 | 0.36 | 0.47 |
Sedation-related complications during ICU stay | ||||||
Agitated (SAS = 5), n (%) | 37 (40.7) | 29 (29.9) | 3 (3.3) | 0.12 | <0.0001 | <0.0001 |
Very agitated (SAS = 6), n (%) | 10 (11) | 6 (6.2) | 3 (3.3) | 0.24 | 0.5 | 0.04 |
Dangerous agitation (SAS = 7), n (%) | 4 (4.4) | 1 (1) | 2 (2.2) | 0.2 | 0.61 | 0.68 |
NGT self-removal, n (%) | 2 (2.2) | 2 (2.1) | 0 (0) | 1 | 0.5 | 0.5 |
ETT self-removal, n (%) | 2 (2.2) | 0 (0) | 0 (0) | 0.23 | - | 0.5 |
Brain CT scans for mental status assessment, n (%) | 1 (1.1) | 0 (0) | 0 (0) | 0.48 | - | 1 |