Evidence map›Paper›PMID 37697129›Full record

ArticleNeurocritical care2024

Enhancing European Management of Analgesia, Sedation, and Delirium: A Multinational, Prospective, Interventional Before-After Trial.

Nicolas Paul, Julius J Grunow, Max Rosenthal, Claudia D Spies, Valerie J Page, James Hanison, Brijesh Patel, Alex Rosenberg, Rebecca von Haken, Urs Pietsch and 9 more

Registry-linked trialAbstract readMulticenter Study
In one paragraph

Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03553719 (Enhancing European Management of Analgesia, Sedation and Delirium - Implementation and Validity of Pain, Agitation and Delirium Screening in the ICU - an International, Prospective Multicenter Observational Trial), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03553719 completednot on this map

Enhancing European Management of Analgesia, Sedation and Delirium - Implementation and Validity of Pain, Agitation and Delirium Screening in the ICU - an International, Prospective Multicenter Observational Trial

TypeobservationalSponsorCharite University, Berlin, GermanyRan2018 to 2020Enrolled430ConditionsDelirium
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Nicolas Paul *Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0003-2228-3980
Julius J Grunow *Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0003-4164-0138
Max RosenthalDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0001-9876-1569
Claudia D SpiesDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0002-1062-0495
Valerie J PageDepartment of Anaesthesia, Watford General Hospital, Watford, Hertfordshire, UK.ORCID 0000-0002-1506-2533
James HanisonManchester Royal Infirmary, Manchester University National Health Service Foundation Trust, Manchester, UK.ORCID 0000-0003-0532-4138
Brijesh PatelDivision of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK.ORCID 0000-0002-5573-2503
Alex RosenbergRoyal Brompton and Harefield National Health Service Foundation Trust, London, UK.
Rebecca von HakenDepartment of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0002-4502-0094
Urs PietschDepartment of Anesthesiology and Intensive Care Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland.ORCID 0000-0001-6957-2638
Claudia SchragClinic of Intensive Care Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Christian WaydhasDepartment of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.ORCID 0000-0002-5291-0853
Peter SchellongowskiDepartment of Medicine I, Medical University of Vienna, Vienna, Austria.ORCID 0000-0001-8982-3131
Elisabeth LobmeyrDepartment of Medicine I, Medical University of Vienna, Vienna, Austria.
Michael SanderDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, UKGM, Justus-Liebig University Giessen, Giessen, Germany.ORCID 0000-0003-1677-3609
Sophie K PiperBerlin Institute of Health, Berlin, Germany.ORCID 0000-0002-0147-8992
Daniel ConwayManchester Royal Infirmary, Manchester University National Health Service Foundation Trust, Manchester, UK.ORCID 0000-0002-4755-2203
Andreas TotzeckDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany.ORCID 0000-0002-1441-9246
Björn WeissDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. bjoern.weiss@charite.de.ORCID 0000-0003-3139-595X

Funding

European Society of Intensive Care Medicine NEXT Start-up Grant
6 · The paper itself

Abstract

backgroundThe objective of this study was to analyze the impact of a structured educational intervention on the implementation of guideline-recommended pain, agitation, and delirium (PAD) assessment.

methodsThis was a prospective, multinational, interventional before-after trial conducted at 12 intensive care units from 10 centers in Germany, Austria, Switzerland, and the UK. Intensive care units underwent a 6-week structured educational program, comprising online lectures, instructional videos, educational handouts, and bedside teaching. Patient-level PAD assessment data were collected in three 1-day point-prevalence assessments before (T1), 6 weeks after (T2), and 1 year after (T3) the educational program.

resultsA total of 430 patients were included. The rate of patients who received all three PAD assessments changed from 55% (107/195) at T1 to 53% (68/129) at T2, but increased to 73% (77/106) at T3 (p = 0.003). The delirium screening rate increased from 64% (124/195) at T1 to 65% (84/129) at T2 and 77% (82/106) at T3 (p = 0.041). The pain assessment rate increased from 87% (170/195) at T1 to 92% (119/129) at T2 and 98% (104/106) at T3 (p = 0.005). The rate of sedation assessment showed no signficiant change. The proportion of patients who received nonpharmacological delirium prevention measures increased from 58% (114/195) at T1 to 80% (103/129) at T2 and 91% (96/106) at T3 (p < 0.001). Multivariable regression revealed that at T3, patients were more likely to receive a delirium assessment (odds ratio [OR] 2.138, 95% confidence interval [CI] 1.206-3.790; p = 0.009), sedation assessment (OR 4.131, 95% CI 1.372-12.438; p = 0.012), or all three PAD assessments (OR 2.295, 95% CI 1.349-3.903; p = 0.002) compared with T1.

conclusionsIn routine care, many patients were not assessed for PAD. Assessment rates increased significantly 1 year after the intervention. Clinical trial registration ClinicalTrials.gov: NCT03553719.

Indexed as

DeliriumAdultAgedAnalgesiaAustriaCritical CareEuropeFemaleGermanyHumansIntensive Care UnitsMaleMiddle AgedPain ManagementPain MeasurementProcedural SedationCritical careDeliriumDelivery of health careEuropeIntensive care units

Identifiers

PMID37697129
PMCPMC11147880

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.