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Randomized Controlled Trial
. 2020 Apr:56:140-144.
doi: 10.1016/j.jcrc.2019.12.018. Epub 2019 Dec 24.

Incidence, risk factors, and outcomes for sepsis-associated delirium in patients with mechanical ventilation: A sub-analysis of a multicenter randomized controlled trial

Tomonori Yamamoto  1 , Yasumitsu Mizobata  2 , Yu Kawazoe  3 , Kyohei Miyamoto  4 , Yoshinori Ohta  5 , Takeshi Morimoto  6 , Hitoshi Yamamura  7
Affiliations
Randomized Controlled Trial

Incidence, risk factors, and outcomes for sepsis-associated delirium in patients with mechanical ventilation: A sub-analysis of a multicenter randomized controlled trial

Tomonori Yamamoto et al. J Crit Care. 2020 Apr.

Abstract

Purpose: This study aimed to investigate incidence, risk factors, and outcomes for sepsis-associated delirium (SAD) in mechanically ventilated patients.

Materials and methods: We performed a retrospective post-hoc analysis of the DExmedetomidine for Sepsis in Intensive care unit Randomized Evaluation (DESIRE) trial. Outcomes included 28-day mortality, ventilator-free days, length of ICU stay, self-extubation, and re-intubation. Multivariable analysis was performed to identify variables independently associated with SAD.

Results: We retrospectively divided the patients into two groups: delirium group (n = 89) and non-delirium group (n = 98). There were no significant differences between the groups in 28-day mortality, self-extubation, and re-intubation. The number of ventilator-free days was significantly less in the delirium vs. non-delirium group (17 vs. 22 days, p = .006), and the length of ICU stay was significantly longer in the delirium group (10 vs. 5 days, p = .04). Multivariable analyses revealed that emergency surgery, more doses of midazolam, and fentanyl were independent predictors for SAD.

Conclusions: SAD was associated with a less number of ventilator-free days and longer length of ICU stay. Emergency surgery, more doses of midazolam, and fentanyl may be independent risk factors for SAD in mechanically ventilated patients with sepsis.

Keywords: Doses of sedatives and analgesics; Mechanically ventilated patients; Risk factors; Sepsis-associated delirium.

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Conflict of interest statement

Declaration of Competing Interest Dr. Yamamura reports receipt of lecture fees from Hospira Japan, Nipro, and Asahi Kasei and educational consulting fees from Toray Industries, CSL Behring, Teijin Pharma, and Nihon Pharmaceutical. Dr. Kawazoe reports receipt of lecture fees from Hospira Japan and Pfizer Japan and a scholarship from Hospira Japan. Dr. Miyamoto reports receipt of lecture fees from Becton Dickinson and Pfizer Japan. Dr. Morimoto reports receipt of lecture fees from AbbVie, AstraZeneca, Daiichi-Sankyo, Kowa, Kyorin, Mitsubishi-Tanabe, and Pfizer Japan and consulting fees from Asahi Kasei and Boston Scientific. The other authors report no disclosures.

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