AUTHOR=Ma Penglin , Wang Tao , Gong Yichun , Liu Jingtao , Shi Wei , Zeng Lin 

TITLE=Factors Associated With Deep Sedation Practice in Mechanically Ventilated Patients: A Post hoc Analysis of a Cross–Sectional Survey Combined With a Questionnaire for Physicians on Sedation Practices

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.839637

DOI=10.3389/fmed.2022.839637

ISSN=2296-858X

ABSTRACT=Purpose: To explore factors associated with deep sedation practice in intensive care unites (ICUs). 
Materials and methods: A post-hoc analysis was done for a cross-sectional survey on sedation practices in mechanically ventilated (MV) patients combined with a questionnaire for physicians regarding their preferences for light sedation (P-pls Score) in 92 Chinese ICUs. 
Results: There were 457 and 127 eligible MV patients in the light and deep sedation group respectively. Multi-variables logistic regression analysis demonstrated that the control mode of mechanical ventilation, plasma lactate level, and the Sequential Organ Failure Assessment (SOFA) score were independent risk factors for deep sedation practice (p<0.01). Notably, the adjusted odds ratio (95% CI) of the average P-pls score in the ICU ≤ 2 for deep sedation practice was 1.861 (1.163, 2.978, p=0.010). In addition, the areas under curves of receiver operating characteristics (AUC-ROC) of the model to predict the probability of deep sedation practice was 0.753 (0.699, 0.806) and 0.772 (0.640, 0.905) in the training set and the validation set respectively. The 28-day mortality was increased in patients with exposure to deep sedation practice, but not significantly.
Conclusion: Both factors related to stressful stimuli and the ICU physician’s perception of patient tolerability in mechanical ventilation were likely associated with deep sedation practice in MV patients.