Evidence map›Paper›PMID 38576856›Full record

ArticleCHEST critical care2024

Variation in Sedative and Analgesic Use During the COVID-19 Pandemic and Associated Outcomes.

Justin M Rucci, Anica C Law, Scott Bolesta, Emily K Quinn, Michael A Garcia, Ognjen Gajic, Karen Boman, Santiago Yus, Valerie M Goodspeed, Vishakha Kumar and 3 more

Open access · diamondAbstract read
In one paragraph

Article in CHEST critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.5field-weighted citation impact, top 12% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Article
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

13 authors at 9 institutions in 2 countries.

Justin M RucciPulmonary Center, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine.
Anica C LawPulmonary Center, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine.
Scott BolestaDepartment of Pharmacy Practice, Nesbitt School of Pharmacy, Wilkes University, Wilkes-Barre, PA.
Emily K QuinnBiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, University of Massachusetts Chan School of Medicine, Worcester MA.
Michael A GarciaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington Medicine Valley Medical Center, Renton, WA.
Ognjen GajicDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
Karen BomanSociety of Critical Care Medicine, Mount Prospect, IL.
Santiago YusDepartment of Intensive Care Medicine, La Paz University Hospital, Madrid, Spain.
Valerie M GoodspeedDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, University of Massachusetts Chan School of Medicine, Worcester MA.
Vishakha KumarSociety of Critical Care Medicine, Mount Prospect, IL.
Rahul KashyapDepartment of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Allan J WalkeyDivision of Health Systems Science, Department of Medicine, University of Massachusetts Chan School of Medicine, Worcester MA.
Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry Investigator Group
University of Washington · USBoston University · USMayo Clinic in Arizona · USSociety of Critical Care Medicine · USUniversity of Massachusetts Chan Medical School · USHospital Universitario La Paz · ESWilkes University · USBeth Israel Deaconess Medical Center · USMayo Clinic · US

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
Boston Biomedical Innovation CenterU54HL119145 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI GOLAN, DAVID E., LOSCALZO, JOSEPH · 2013 to 2021
$18.8M
Efficacy of self-management of sedative therapy by ventilated ICU patientsR01HL130881 · NHLBI · MAYO CLINIC ROCHESTER · PI CHLAN, LINDA L, TRACY, MARY FRANCES · 2016 to 2021
$3.2M
Targeting cardiovascular events to improve patient outcomes after sepsisR01HL139751 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI WALKEY, ALLAN J. · 2018 to 2021
$2.8M
Acute Care Learning Laboratory - Reducing Threats to Diagnostic Fidelity in Critical IllnessR18HS026609 · AHRQ · MAYO CLINIC ROCHESTER · PI PICKERING, BRIAN W · 2018 to 2021
$2.4M
Evaluating Routine Opioid Use during Acute Respiratory FailureR01HL151607 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LIU, VINCENT, WALKEY, ALLAN J. · 2020 to 2023
$2.3M
Automated detection and prediction of atrial fibrillation during sepsisR01HL136660 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI WALKEY, ALLAN J. · 2017 to 2020
$2.2M
Advanced Risk Adjusters and Predictive Formulas for ICD-10 Based Risk AdjustmentR01HS026485 · AHRQ · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI ELLIS, RANDALL P. · 2018 to 2020
$1.2M
Prolonged mechanical ventilation: patterns of post-acute care and patient outcomesK23HL153482 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI LAW, ANICA C · 2020 to 2024
$891k
AHRQ HHS R01 HS026485AHRQ HHS R18 HS026609NCATS NIH HHS UL1 TR002377NHLBI NIH HHS K23 HL153482NHLBI NIH HHS R01 HL130881NHLBI NIH HHS R01 HL136660NHLBI NIH HHS R01 HL139751NHLBI NIH HHS R01 HL151607NHLBI NIH HHS U54 HL119145
6 · The paper itself

Abstract

backgroundProviding analgesia and sedation is an essential component of caring for many mechanically ventilated patients. The selection of analgesic and sedative medications during the COVID-19 pandemic, and the impact of these sedation practices on patient outcomes, remain incompletely characterized. RESEARCH QUESTION: What were the hospital patterns of analgesic and sedative use for patients with COVID-19 who received mechanical ventilation (MV), and what differences in clinical patient outcomes were observed across prevailing sedation practices? STUDY DESIGN AND

methodsWe conducted an observational cohort study of hospitalized adults who received MV for COVID-19 from February 2020 through April 2021 within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry. To describe common sedation practices, we used hierarchical clustering to group hospitals based on the percentage of patients who received various analgesic and sedative medications. We then used multivariable regression models to evaluate the association between hospital analgesia and sedation cluster and duration of MV (with a placement of death [POD] approach to account for competing risks).

resultsWe identified 1,313 adults across 35 hospitals admitted with COVID-19 who received MV. Two clusters of analgesia and sedation practices were identified. Cluster 1 hospitals generally administered opioids and propofol with occasional use of additional sedatives (eg, benzodiazepines, alpha-agonists, and ketamine); cluster 2 hospitals predominantly used opioids and benzodiazepines without other sedatives. As compared with patients in cluster 2, patients admitted to cluster 1 hospitals underwent a shorter adjusted median duration of MV with POD (β-estimate, -5.9; 95% CI, -11.2 to -0.6;

interpretationPatients who received MV for COVID-19 in hospitals that prioritized opioids and propofol for analgesia and sedation experienced shorter adjusted median duration of MV with POD as compared with patients who received MV in hospitals that primarily used opioids and benzodiazepines.

Indexed as

acute respiratory failureanalgesiaCOVID-19mechanical ventilationsedation

Identifiers

PMID38576856
PMCPMC10994221
OpenAlexW4390685378

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.