Práticas de sedoanalgesia em pacientes graves em um hospital militar.

Abstract

Objective: This study examined local practices associated with the use of analgesic and sedative therapy and management of delirium in mechanically ventilated patients in the current year. Methodology: This is a retrospective and observational study carried out between August and December 2022, in intensive care units I and II of HNMD. Sixty-nine patients aged 18 years or older on mechanical ventilation admitted from January to November 2022 were included, divided into clinical, surgical, obstetric and neurological. The following data were evaluated: Age, gender, admission diagnosis and its category (clinical or surgical), medications received, objective assessment of pain, sedation and delirium, use of neuromuscular blockers, use of physical restraint and clinical outcomes (length of stay in intensive care and in the hospital, duration of mechanical ventilation and death). Results: The average SAPS3 on admission was 56%, the main diagnosis found was sepsis. Men accounted for 54% of the total number of patients. 46% of the patients died. The presence of delirium was 11%; The use of restrictors was found in 10% of patients. 13% of patients had device avulsion. The main strategy used for sedoanalgesia was the combined use of Midazolam and Fentanyl. The average time of mechanical ventilation was 19 days. Conclusion: The study reinforces the need for systematic adoption of protocols, bundles and SOPs that favor the improvement of clinical practice in the recognition, prevention and treatment of conditions, with the aim of improving clinical and managerial outcomes.