a systematic review of the impact of sedation practice in the icu on resource use, costs and patient safety系统回顾镇静实践的影响在icu资源使用、成本和病人安全.pdfVIP

Jackson et al. Critical Care 2010, 14:R59 /content/14/2/R59 R E S E A R C H Open Access Research A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety 1 2 2 3 Daniel L Jackson* , Clare W Proudfoot , Kimberley F Cann and Tim Walsh Abstract Introduction: Patients in intensive care units (ICUs) often receive sedation for prolonged periods. In order to better understand the impact of sub-optimal sedation practice on outcomes, we performed a systematic review, including observational studies and controlled trials which were conducted in sedated patients in the ICU and which compared the impact of changes in or different protocols for sedation management on economic and patient safety outcomes. Methods: We searched Medline, Embase and CINAHL online literature databases from 1988 to 15th May 2008 and hand searched conferences. English-language studies set in the ICU, in sedated adult humans on mechanical ventilation, which reported the impact of sedation practice on cost and resource use and patient safety outcomes, were included. All abstracts were reviewed twice by two independent reviewers, with all conflicts resolved by a third reviewer, to check that they met the review inclusion criteria. Full-text papers of all included studies were retrieved and again reviewed twice against inclusion criteria. Data were doubly extracted from studies. Study aims, design, population, and outcomes including duration of mechanical ventilation, length of stay in ICU and hospital, costs and rates of mortality and adverse events were extracted. Due to heterogeneity between study designs and outcomes reported, no quantitative data synthesis such as meta-analysis was possible. Results: Includ