Sedation Usage in COVID-19 Acute Respiratory Distress Syndrome: A Multicenter Study. Journal Article

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Authors: Tapaskar, N; Colon Hidalgo, D; Koo, G; Shingada, K; Rao, S; Rodriguez, R; Alcantar, D; Espinoza Barrera, D; Lee, R; Rameshkumar, N; Amine, M; Rodrigues, S; Giron, F; Chaugule, A; Rech, MA
Article Title: Sedation Usage in COVID-19 Acute Respiratory Distress Syndrome: A Multicenter Study.
Abstract: BACKGROUND: Patients with COVID-19 acute respiratory distress syndrome (ARDS) have been shown to have high sedation requirements. OBJECTIVE: The purpose of this study was to compare sedative use between patients with COVID-19 ARDS and non-COVID-19 ARDS. METHODS: This was a retrospective study of patients with COVID-19 ARDS compared with historical controls of non-COVID-19 ARDS who were admitted to 2 hospitals from March 1, 2020, to April 30, 2020, and April 1, 2018, to December 31, 2019, respectively. The primary outcome was median cumulative dose of propofol (μg/kg) at 24 hours after intubation. RESULTS: There were 92 patients with COVID-19 ARDS and 37 patients with non-COVID-19 ARDS included. Within the first 24 hours of intubation, patients with COVID-19 ARDS required higher total median doses of propofol: 51 045 μg/kg (interquartile range, 26 150-62 365 μg/kg) versus 33 350 μg/kg (9632-51 455 μg/kg; = 0.004). COVID-19 patients were more likely receive intravenous lorazepam (37% vs 14%; = 0.02) and higher cumulative median doses of midazolam by days 5 (14 vs 4 mg; = 0.04) and 7 of intubation (89 vs 4 mg; = 0.03) to achieve the same median Richmond Analgesia-Sedation Scale scores. COVID-19 ARDS patients required more ventilator days (10 vs 6 days; = 0.02). There was no difference in 30-day mortality. CONCLUSION AND RELEVANCE: Patients with COVID-19 ARDS required higher doses of propofol and benzodiazepines than patients with non-COVID-19 ARDS to achieve the same median levels of sedation.
Journal Title: The Annals of Pharmacotherapy
ISSN: 1542-6270; 1060-0280
Publisher: Unknown  
Date Published: 2021