In this episode, I’ll discuss the 4 factors that predict agitation in lightly sedated ventilated patients.
Light sedation is encouraged in ventilated patients due to less delirium. However agitation is one of the risks of a light sedation strategy. If the agitation is not treated in time, a patient may self-extubate or otherwise put themselves at risk.
A predictive model of agitation risk factors was developed and published in Critical Care Medicine.
The model showed 4 factors predicted agitation within the following 24 hours:
1. Higher body temperature (odds ratio for 1°C increase: 5.29; 95% CI, 3.70–7.84; p < 0.001)
2. Greater minute ventilation (odds ratio for 1 L/min increase: 1.15; 95% CI, 1.02–1.30; p = 0.019)
3. Higher Richmond Agitation-Sedation Scale (odds ratio for 1-point increase: 2.43; 95% CI, 1.92–3.16; p < 0.001)
4. Days on invasive mechanical ventilation (odds ratio for 1-d increase: 0.95; 95% CI, 0.93–0.98; p = 0.001)
Being able to predict agitation in advance could lead to decisions on increased monitoring, quicker treatment, or even changes in sedation levels.
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