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Risk factors and prognosis of pain events during mechanical ventilation: a retrospective study

Overview of attention for article published in Journal of Intensive Care, February 2017
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Title
Risk factors and prognosis of pain events during mechanical ventilation: a retrospective study
Published in
Journal of Intensive Care, February 2017
DOI 10.1186/s40560-017-0212-5
Pubmed ID
Authors

Ayahiro Yamashita, Masaki Yamasaki, Hiroki Matsuyama, Fumimasa Amaya

Abstract

Pain assessment is highly recommended in patients receiving mechanical ventilation. However, pain intensity and its impact on outcomes in these patients remain obscure. We collected the results of routine pain assessments, utilizing the behavioral pain scale (BPS), from 151 patients receiving mechanical ventilation. Risk factors associated with a pain event, defined as BPS of >5, and its impact on patient outcomes were investigated. A total of 151 consecutive adult patients receiving mechanical ventilation for more than 24 h in a single 10-bed ICU were enrolled in this study. The highest BPS within 48 h after the initiation of mechanical ventilation was collected, as well as information about the patients' characteristics and medication received. We also recorded patient outcomes, including time to successful weaning from mechanical ventilation, time to successful ICU discharge, and 30-day in-hospital mortality. Multivariate logistic regression analysis was used to determine factors independently associated with patients with a BPS of >5. Clinical outcomes were also assessed using multivariate logistic regression analysis, correcting for risk factors. We analyzed 151 patients. The median highest BPS was 4. The percentage of patients who recorded a BPS of >5 was 19.9% (n = 30). Multivariate logistic regression analysis revealed that the disuse of fentanyl and inotropic support was an independent predictor of pain event. Multivariable Cox regression analysis suggested that the development of a BPS of >5 was associated with increased mortality and a not statistically significant trend towards prolonged mechanical ventilation. A significant proportion of ventilated patients experienced a BPS of >5 soon after the initiation of mechanical ventilation. Disuse of fentanyl and use of inotropic agents increased the risk of developing a BPS of >5 during mechanical ventilation. An association between adequate analgesia and improved patient outcomes provides a rationale for the assessment of pain during mechanical ventilation, with subsequent intervention if necessary. Pain events were common among ventilated patients. In critical care settings, appropriate and adequate pain management is warranted, given the association with improved patient outcomes.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 3%
Unknown 39 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 20%
Other 5 13%
Student > Ph. D. Student 4 10%
Lecturer 3 8%
Professor > Associate Professor 3 8%
Other 7 18%
Unknown 10 25%
Readers by discipline Count As %
Nursing and Health Professions 14 35%
Medicine and Dentistry 6 15%
Agricultural and Biological Sciences 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Computer Science 1 3%
Other 3 8%
Unknown 13 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 February 2017.
All research outputs
#11,708,497
of 13,188,189 outputs
Outputs from Journal of Intensive Care
#271
of 301 outputs
Outputs of similar age
#285,450
of 344,803 outputs
Outputs of similar age from Journal of Intensive Care
#1
of 1 outputs
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