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Are We Using the Appropriate dose of Sedatives during RSI? : Retrospective Observational Study in Two Emergency Centers
Journal of the Korean Society of Emergency Medicine ; : 508-513, 2007.
Artigo em Coreano | WPRIM | ID: wpr-159115
ABSTRACT

PURPOSE:

The use of rapid sequence intubation (RSI) by emergency physicians in emergency departments is increasing. Our aim was to evaluate the current practice of RSI, focusing particularly on the appropriateness of sedative dose.

METHODS:

We retrospectively investigated RSI cases in two urban emergency centers occurring between June 2005 and May 2006. We calculated the sedative dose used per patients' weight and divided into a low dose group (less than the minimum recommended dose) and a full dose group. We investigated the differences between these two groups, including hemodynamic changes, success rates and complication rates.

RESULTS:

Of 745 cases of endotracheal intubation performed, 211 cases were defined as RSI cases. The mean sedative dose was 0.29 mg/kg (+/-0.08 SD) for etomidate and 0.08 mg/kg (+/-0.03 SD) for midazolam. Sedatives were underdosed in 56.3% of etomidate cases and 82.1% of midazolam cases, for a mean underdose rate of 63.6%. Drops in SBP (systolic blood pressure) were significantly different between the etomidate and midazolam groups (-14.4 mmHg vs -22.43 mmHg, p=0.04), but there was no significant difference in SBP between low dose and full dose groups. The overall complication rate was 17.1%, was again with no significant difference between full dose and low dose groups.

CONCLUSION:

Overall, sedatives were underdosed in 63.6% of cases with midazolam more frequently underdosed than etomidate. However, the underdosing of sedatives was not significantly correlated with the first pass rate or the complication rate.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Midazolam / Estudos Retrospectivos / Emergências / Serviço Hospitalar de Emergência / Etomidato / Estudo Observacional / Hemodinâmica / Hipnóticos e Sedativos / Intubação / Intubação Intratraqueal Tipo de estudo: Estudo observacional Idioma: Coreano Revista: Journal of the Korean Society of Emergency Medicine Ano de publicação: 2007 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Midazolam / Estudos Retrospectivos / Emergências / Serviço Hospitalar de Emergência / Etomidato / Estudo Observacional / Hemodinâmica / Hipnóticos e Sedativos / Intubação / Intubação Intratraqueal Tipo de estudo: Estudo observacional Idioma: Coreano Revista: Journal of the Korean Society of Emergency Medicine Ano de publicação: 2007 Tipo de documento: Artigo