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. 2014 Apr-Jun;26(2):122-9.
doi: 10.5935/0103-507x.20140018.

Sedation and memories of patients subjected to mechanical ventilation in an intensive care unit

[Article in English, Portuguese]
Jaquilene Barreto da Costa  1 , Sonia Silva Marcon  2 , Claudia Rejane Lima de Macedo  3 , Amaury Cesar Jorge  4 , Péricles Almeida Delfino Duarte  4
Affiliations

Sedation and memories of patients subjected to mechanical ventilation in an intensive care unit

[Article in English, Portuguese]
Jaquilene Barreto da Costa et al. Rev Bras Ter Intensiva. 2014 Apr-Jun.

Abstract
in English, Portuguese

Objective: To investigate the relationship between sedation and the memories reported by patients subjected to mechanical ventilation following discharge from the intensive care unit.

Methods: This prospective, observational, cohort study was conducted with individuals subjected to mechanical ventilation who remained in the intensive care unit for more than 24 hours. Clinical statistics and sedation records were extracted from the participants' clinical records; the data relative to the participants' memories were collected using a specific validated instrument. Assessment was performed three months after discharge from the intensive care unit.

Results: A total of 128 individuals were assessed, most of whom (84.4%) reported recollections from their stay in the intensive care unit as predominantly a combination of real and illusory events. The participants subjected to sedation (67.2%) at deep levels (Richmond Agitation-Sedation Scale [RASS] -4 and -5) for more than two days and those with psychomotor agitation (33.6%) exhibited greater susceptibility to occurrence of illusory memories (p>0.001).

Conclusion: The probability of the occurrence of illusory memories was greater among the participants who were subjected to deep sedation. Sedation seems to be an additional factor that contributed to the occurrence of illusory memories in severely ill individuals subjected to mechanical ventilation.

Objetivo: Investigar a relação entre sedação e as memórias relatadas por pacientes submetidos à ventilação mecânica após a alta da unidade de terapia intensiva.

Métodos: Estudo de coorte prospectivo, observacional, realizado com pacientes submetidos à ventilação mecânica e que permaneceram por mais de 24 horas na unidade de terapia intensiva. Dados clínicos e de sedação foram pesquisados em prontuários, e os dados referentes às memórias do paciente foram coletados por meio de um instrumento validado para esse fim. As avaliações foram realizadas 3 meses após a alta da unidade de terapia intensiva.

Resultados: Dos 128 pacientes avaliados, a maioria (84,4%) relatou lembranças do período de internação na unidade de terapia intensiva, prevalecendo uma combinação de eventos reais e ilusórios. Pacientes que permaneceram sedados (67,2%), com sedação profunda (RASS -4 e -5) durante um período maior do que 2 dias e que apresentaram agitação psicomotora (33,6%) foram mais suscetíveis a apresentarem memórias ilusórias (p>0,001).

Conclusão: A probabilidade de os pacientes apresentarem memórias de ilusão foi maior naqueles com sedação profunda. A sedação, portanto, parece ser um fator adicional que contribuiu para o desenvolvimento de memórias ilusórias em pacientes gravemente enfermos e submetidos à ventilação mecânica.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Flowchart of individuals admitted to the intensive care unit during the study period. ICU - intensive care unit.
See this image and copyright information in PMC

Comment in

  • Sedation and memories in critical care.
    Shinotsuka CR, Serafim RB. Shinotsuka CR, et al. Rev Bras Ter Intensiva. 2014 Apr-Jun;26(2):81-2. doi: 10.5935/0103-507x.20140014. Rev Bras Ter Intensiva. 2014. PMID: 25028941 Free PMC article. No abstract available.

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