ArticleLife (Basel, Switzerland)2022
Excessive Sedation as a Risk Factor for Delirium: A Comparison between Two Cohorts of ARDS Critically Ill Patients with and without COVID-19.
Article in Life (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Consensus statement for managing patients with ARDS in low-resource settings: a Delphi study.Annals of intensive care · 2026Article
- Sedation Practices for Intubated Patients with COVID-19 and non-COVID-19 Acute Respiratory Distress Syndrome and its Effects on Clinical Outcomes.Acta medica Philippina · 2026Article
- Clinical Predictors of Weaning Failure and Mortality in Individuals With COVID-19 Undergoing Invasive Mechanical Ventilation: A Retrospective Cohort Study.Pulmonary medicine · 2026Article
- Ventilator-Induced Lung Injury: The Unseen Challenge in Acute Respiratory Distress Syndrome Management.Journal of clinical medicine · 2025Review
- Analysis of Risk Factors and Development of a Predictive Model for Delirium in ICU Patients: Construction, Validation, and Clinical Implications.International journal of general medicine · 2025Article
- Combining OJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Review
- Characteristics and Outcomes of Tracheostomized Patients With and Without COVID-19.Critical care explorations · 2023Article
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16 authors at 7 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
Excessive sedation is associated with poor outcome in critically ill acute respiratory distress syndrome (ARDS) patients. Whether this prognostic effect varies among ARDS patients with and without COVID-19 has yet to be determined. We compared the prognostic value of excessive sedation—in terms of delirium, length of stay in intensive care unit (ICU-LOS) and ICU mortality—between COVID-19 and non-COVID-19 critically ill ARDS patients. This was a second analysis of prospectively collected data in four European academic centers pertaining to 101 adult critically ill ARDS patients with and without COVID-19 disease. Depth of sedation (DOS) and delirium were monitored through processed electroencephalogram (EEG) and the Confusion Assessment Method for ICU (CAM-ICU). Our main exposure was excessive sedation and how it relates to the presence of delirium, ICU-LOS and ICU mortality. The criterion for excessive sedation was met in 73 (72.3%) patients; of these, 15 (82.2%) and 58 (69.1%) were in non-COVID-19 and COVID-19 ARDS groups, respectively. The criteria of delirium were met in 44 patients (60.3%). Moreover, excessive sedation was present in 38 (86.4%) patients with delirium (p < 0.001). ICU death was ascertained in 41 out of 101 (41.0%) patients; of these, 37 (90.2%) had excessive sedation (p < 0.001). The distribution of ICU-LOS among excessive-sedated and non-sedated patients was 22 (16−27) vs. 14 (10.5−19.5) days (p < 0.001), respectively. In a multivariable framework, excessive sedation was independently associated with the development of delirium (p = 0.001), increased ICU mortality (p = 0.009) and longer ICU-LOS (p = 0.000), but only in COVID-19 ARDS patients. Independent of age and gender, excessive sedation might represent a risk factor for delirium in COVID-19 ARDS patients. Similarly, excessive sedation shows to be an independent predictor of ICU-LOS and ICU mortality. The use of continuous EEG-based depth of sedation (DOS) monitoring and delirium assessment in critically ill COVID-19 patients is warranted.
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