Influencing factors analysis of sedative tolerance in ICU patients on mechanical ventilation#br#
HUANG Bing1 TANG Zhihong2 TANG Li1
1.Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, Chengdu 610041, China;
2.Department of Intensive Care, West China Hospital, Sichuan University, Sichuan Province, Chengdu 610041, China
Abstract：Objective To investigate the influencing factors of sedative tolerance in ICU patients, so as to provide reference for formulating corresponding medical care measures. Methods Electronic medical records of 372 patients undergoing sedative and analgesic mechanical ventilation in West China Hospital, Sichuan University from February 2017 to March 2021 were retrospectively collected, and they were divided into the tolerant group (60 cases) and the non-tolerant group (312 cases) according to the incidence of sedative tolerance. Univariate analysis and logistic regression model were used to explore the factors associated with sedative tolerance in patients. Results The age, scores of acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) in the tolerant group were lower than those in the non-tolerant group, the body mass index, proportion of patients with drinking history and repeated intermitten push injection were higher than those in the non-tolerant group, the use time of sedative was longer than that of non-tolerant group, and the differences were statistically significant (P ＜ 0.05). Multivariate analysis showed that age, APACHE Ⅱ score, alcohol consumption, duration of sedative use, and repeated intermitten push injection were independent influencing factors of sedative tolerance (P ＜ 0.05). Conclusion For patients who are prone to sedative tolerance after sedative and analgesic mechanical ventilation, clinical attention should be paid to the use of sedative drugs in severe patients and management standards should be formulated, and measures should be actively taken to reduce the occurrence of sedative tolerance and protect the safety of patients.
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