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Oversedation in postoperative patients requiring ventilator support greater than 48 hours: a 4-year National Surgical Quality Improvement Program-driven project


, : Oversedation in postoperative patients requiring ventilator support greater than 48 hours: a 4-year National Surgical Quality Improvement Program-driven project. American Surgeon 79(10): 1106-1110

Prolonged mechanical ventilation of postoperative patients can contribute to an increase in morbidity. Every effort should be made to wean patients from the ventilator after surgery. Oversedation may prevent successful extubation. Cases identified by the National Surgical Quality Improvement Program (NSQIP) for Huntington Hospital were reviewed. Oversedation, days on the ventilator, type and duration of sedation, and cost were studied. Data were collected from the NSQIP database and patient charts. Oversedation was determined by the Richmond Agitation Sedation Score (RASS) of each patient. The hospital pharmacy provided data on propofol. Forty-three (35%) patients were oversedated. Propofol was used in 111 (90%) cases with an average use of 4.8 days. Propofol was used greater than 48 hours in 77 (62%) cases. After identifying inconsistent nurse documentation of sedation, corrective actions helped decrease oversedation, average number of days on the ventilator, number of days on propofol, hospital expenditure on propofol, and number of patients on the ventilator greater than 48 hours. Oversedation contributed to prolonged mechanical ventilation. Standardization of RASS and physician sedation order sheets contributed to improving our NSQIP rating. Sedation use decreased and fewer patients spent less time on the ventilator. NSQIP is an effective tool to identify issues with quality in surgical patients.

US$29.90

PMID: 24160809


Other references

Sleno, L.; Volmer, D.A.; Kovacević, B.; Maksić, Z.B., 2004: Gas-phase dissociation reactions of protonated saxitoxin and neosaxitoxin. The aim of this study was to investigate the behavior of the protonated paralytic shellfish poisons saxitoxin (STX) and neosaxitoxin (NEO) in the gas-phase after ion activation using different tandem mass spectrometry techniques. STX and NEO belon...

Zhang, R.; Yuan, Y.; Liang, J.; Kwok, R.T.K.; Zhu, Q.; Feng, G.; Geng, J.; Tang, B.Zhong.; Liu, B., 2015: Fluorogen-peptide conjugates with tunable aggregation-induced emission characteristics for bioprobe design. Fluorogens with aggregation-induced emission (AIE) characteristics are attracting intense research interest, and an AIE-peptide conjugate strategy has been reported for developing turn-on probes based on hydrophilic peptide ligands. To build a mod...

Zheng, L.; Shen, X-Heng.; Wang, Y.; Li, W.; Zhai, Y.; Tang, X-Mei.; Yuan, C-Xing.; Chen, Y.; Li, J.; Xia, X., 2004: Effect of Baisuifang Granule on cognitive malfunction after cerebral infarction. To explore the mechanism of Baisuifang Granule in treating cognitive malfunction after cerebral infarction. One hundred and sixty patients with cerebral infarction were divided randomly into two groups. Eighty patients were treated with Baisuifang...

Williams, D.A.; Hale, A.M., 2006: Helper effects on offspring production in cooperatively breeding brown jays (Cyanocorax morio). Most studies of cooperatively breeding species have revealed that indirect fitness gains from helping are lower than benefits gained from direct reproduction. Exceptions to this "best of a bad job" strategy are rare. Brown Jays (Cyanocor...

Wang, D-Cai.; Song, H.; Yang, C.; Huang, W-Cai.; Yao, S., 2012: 2-Chloro-N-(4-chloro-3-iodo-phen-yl)-4-(methyl-sulfon-yl)benzamide. In the title compound, C(14)H(10)Cl(2)INO(3)S, the dihedral angle between the benzene rings is 52.13 (10)°. In the crystal, the components are linked by pairs of N-H⋯O(sulfon-yl) hydrogen bonds into centrosymmetric dimers.

Elluru, R.G.; Bloom, G.S.; Brady, S.T., 1995: Fast axonal transport of kinesin in the rat visual system: functionality of kinesin heavy chain isoforms. The mechanochemical ATPase kinesin is thought to move membrane-bounded organelles along microtubules in fast axonal transport. However, fast transport includes several classes of organelles moving at rates that differ by an order of magnitude. Fur...

Dul'gerov, A.N., 1977: Dynamics of soil gas composition during irrigation. Mikrobiolohichnyi Zhurnal 39(6): 719-722

Rao T.B.S.; Reddy G.P.V.; Murthy M.M.K.; Prasad V.D., 1991: Efficacy of neem products in the control of bhendi pest complex. Nine insecticide spray schedules were evaluated against aphids [Aphis gossypii], jassids [Amrasca biguttula] and fruit borers [Earias vittella] of bhendi [Abelmoschus esculentus] in kharif and rabi seasons of 1989-90 at the Agricultural College fa...

Benoit, F., 1974: PCNB residues in head lettuce under glass. Data are presented on the average plant weight and the quintozene, hexachlorobenzene, pyrazon and dichloran harvest residues on head lettuces following a pre- or post-planting application of Brassicol (quintozene) at 40 or 400 g/are or of Asepta-C...

Entrikin, R.K.; Erway, L.C., 1972: A genetic investigation of roller and tumbler pigeons. Genetic data obtained from 209 pigeons indicate a single major gene (ro) with modifying genes as the hereditary basis for the rolling phenomenon.