Analgosedation practice during noninvasive respiratory supports: Results from an Italian survey

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2025-04-12 DOI:10.1016/j.jcrc.2025.155080

G. Spinazzola , G. Ferrone , G. Cammarota , A. Cortegiani , S.M. Maggiore , N. Patroniti , G. Cinnella , L. Cabrini , S. Grasso , G. Conti , M. Antonelli , D.L. Grieco , L. Ball , G. Misseri , C. Gregoretti , A. Giarratano , S. Spadaro

{"title":"Analgosedation practice during noninvasive respiratory supports: Results from an Italian survey","authors":"G. Spinazzola , G. Ferrone , G. Cammarota , A. Cortegiani , S.M. Maggiore , N. Patroniti , G. Cinnella , L. Cabrini , S. Grasso , G. Conti , M. Antonelli , D.L. Grieco , L. Ball , G. Misseri , C. Gregoretti , A. Giarratano , S. Spadaro","doi":"10.1016/j.jcrc.2025.155080","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>There are currently no established guidelines pertaining the application of analgosedation strategies for patients undergoing Noninvasive Respiratory Supports (NRSs) for acute respiratory failure treatment. The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) conducted a nation-wide survey to describe the current clinical practice in the management of analgosedation during NRSs.</div></div><div><h3>Methods</h3><div>This is a nationwide online survey, involving Italian anesthesiologist-intensivists, developed by experts affiliated with SIAARTI. Invitations to participate were distributed via emails and social networks. Data were collected over a period of three months (March 16 to May 10, 2024).</div></div><div><h3>Results</h3><div>Two hundred and seventy-seven full responses were collected. Most respondents were attending physician (83 %), with <10 years of ICU experience (56 %) and work in ICU medical department (75 %). In terms of optimizing the NRS success, 80 % of respondents used a pharmacological strategy and 50 % of respondents did not use a non-pharmacological strategy. Dexmedetomidine was the most commonly administered drug (82 %), followed by morphine and remifentanil. Additionally, 33 % of respondents reported using a combination of dexmedetomidine and remifentanil as part of their pharmacological strategy during NRSs. Concerning the motivations for analgosedation use during NRSs, over 80 % of respondents aimed to improve patient-ventilator interaction, more than 60 % focused on reducing patient anxiety and dyspnea, 59 % sought for having a lower respiratory rate, and only 40 % prioritized pain reduction.</div></div><div><h3>Conclusion</h3><div>Sedation is frequently used in patients with acute respiratory failure undergoing NRSs. Current analgesic practices are becoming more standardized, with analgosedation strategies increasingly tailored to individual patient characteristics.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155080"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of critical care","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S088394412500067X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

There are currently no established guidelines pertaining the application of analgosedation strategies for patients undergoing Noninvasive Respiratory Supports (NRSs) for acute respiratory failure treatment. The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) conducted a nation-wide survey to describe the current clinical practice in the management of analgosedation during NRSs.

Methods

This is a nationwide online survey, involving Italian anesthesiologist-intensivists, developed by experts affiliated with SIAARTI. Invitations to participate were distributed via emails and social networks. Data were collected over a period of three months (March 16 to May 10, 2024).

Results

Two hundred and seventy-seven full responses were collected. Most respondents were attending physician (83 %), with <10 years of ICU experience (56 %) and work in ICU medical department (75 %). In terms of optimizing the NRS success, 80 % of respondents used a pharmacological strategy and 50 % of respondents did not use a non-pharmacological strategy. Dexmedetomidine was the most commonly administered drug (82 %), followed by morphine and remifentanil. Additionally, 33 % of respondents reported using a combination of dexmedetomidine and remifentanil as part of their pharmacological strategy during NRSs. Concerning the motivations for analgosedation use during NRSs, over 80 % of respondents aimed to improve patient-ventilator interaction, more than 60 % focused on reducing patient anxiety and dyspnea, 59 % sought for having a lower respiratory rate, and only 40 % prioritized pain reduction.

Conclusion

Sedation is frequently used in patients with acute respiratory failure undergoing NRSs. Current analgesic practices are becoming more standardized, with analgosedation strategies increasingly tailored to individual patient characteristics.

查看原文本刊更多论文

无创呼吸支持期间的镇痛镇静实践：来自意大利的一项调查结果

目的：在急性呼吸衰竭患者接受无创呼吸支持（NRSs）治疗时，目前尚无关于镇痛镇静策略应用的既定指南。意大利麻醉、镇痛、复苏和重症监护学会（SIAARTI）进行了一项全国范围的调查，以描述目前nrs期间镇痛镇静管理的临床实践。方法：这是一项全国性的在线调查，由SIAARTI下属的专家开展，涉及意大利麻醉医师和重症医师。参加邀请是通过电子邮件和社交网络分发的。数据收集时间为三个月（2024年3月16日至5月10日）。结果共收集完整问卷277份。大多数受访者为主治医师（83%），具有10年ICU工作经验（56%），在ICU内科工作（75%）。在优化NRS成功方面，80%的受访者使用药理学策略，50%的受访者不使用非药理学策略。右美托咪定是最常用的药物（82%），其次是吗啡和瑞芬太尼。此外，33%的应答者报告使用右美托咪定和瑞芬太尼联合作为nrs期间药理学策略的一部分。关于nrs期间使用镇痛镇静的动机，超过80%的受访者旨在改善患者与呼吸机的互动，超过60%的受访者专注于减少患者的焦虑和呼吸困难，59%的受访者寻求更低的呼吸频率，只有40%的人优先考虑减轻疼痛。结论镇静是急性呼吸衰竭患者行非体外循环治疗的常用药物。目前的镇痛实践正变得更加标准化，与镇痛镇静策略越来越适合个别患者的特点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.