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Med Intensiva. 2019 May;43(4):225-233. doi: 10.1016/j.medin.2018.12.003. Epub 2019 Jan 28.

Management of analgesia, sedation and delirium in Spanish Intensive Care Units: A national two-part survey.

[Article in English, Spanish]

Author information

1
Hospital Virgen Macarena, Sevilla, España. Electronic address: manuelagarcisan@hotmail.com.
2
Hospital Arnau de Vilanova, IRBLleida, Universitat Autònoma de Barcelona, Lérida, España.
3
Clínica Quirón Palmaplanas, Palma de Mallorca, España.
4
Hospital Vega Baja, Orihuela (Alicante), España.
5
Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
6
Hospital San Carlos, Madrid, España.
7
Hospital Cruces, Barakaldo, España.
8
Hospital Central de Asturias, Oviedo, España.
9
Hospital Bellvitge, Hospitalet de Llobregat, España.
10
Hospital Infanta Leonor, Madrid, España.

Abstract

OBJECTIVE:

To know the real clinical practice of Spanish ICUs in relation to analgesia, sedation and delirium, with a view to assessing adherence to current recommendations.

DESIGN:

A descriptive cross-sectional study was carried out based on a national survey on analgesia, sedation and delirium practices in patients admitted to intensive care on 16 November, 2013 and 16 October, 2014. An on-line questionnaire was sent with the endorsement of the SEMICYUC.

SETTING:

Spanish ICUs in public and private hospitals.

RESULTS:

A total of 166 ICUs participated, with the inclusion of 1567 patients. The results showed that 61.4% of the ICUs had a sedation protocol, and 75% regularly monitored sedation and agitation - the RASS being the most frequently used scale. Pain was monitored in about half of the ICUs, but the behavioral scales were very little used. Delirium monitoring was implemented in few ICUs. Among the patients on mechanical ventilation, midazolam remained a very commonly used agent.

CONCLUSIONS:

This survey is the first conducted in Spain on the practices of analgesia, sedation and delirium. We identified specific targets for quality improvement, particularly concerning the management of sedation and the assessment of delirium.

KEYWORDS:

Analgesia; Delirium; Intensive Care Units; Prácticas de sedación; Survey of sedation; Unidad de Cuidados Intensivos

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