Use of BRASS in sedated critically-ill patients as a predictable mortality factor: BRASS-ICU.
Neurol Res
; 43(4): 283-290, 2021 Apr.
Article
em En
| MEDLINE
| ID: mdl-33208055
ABSTRACT
Objectives:
To demonstrate that a BRASS score≥ 3 at admission of intubated, ventilated and sedated patients is predictive of mortalityMethods:
we have realized an Observational prospective multicenter study.All Major patients without neurological history, admitted to ICU for a non-neurological cause, sedated and admitted under mechanical ventilation were included.Results:
One hundred and ten patients were included, the BRASS score as well as the FOUR and RASS scores were collected.At day 28, patients with a BRASS score ≥ 3 had an excess mortality (OR 3.29 - CI 95% [1.42-7.63], p = 0.005) as well as day 90 (OR 2.65 - CI 95% [1.19-5.88], p = 0.02), without impact on the delirium measured by CAM-ICU (OR 1.8 - CI 95% [0.68-4.77], p = 0.023). After adjustment with SAPS II, FOUR and RASS, difference in mortality was not any more different.It is also noted that patients with BRASS ≥ 3 are more sedated (RASS -5 [-5 - -5] vs -4 [-5 - -3], p < 0.0001) and more comatose (FOUR 2 [1-4] vs 6 [4-9], p < 0.0001), and have higher doses of midazolam (10 mg/h [5-15] vs 7.5 mg/h [5-10], p = 0.02) and sufentanil (20 µg/h [15-22.5] vs 10 [10-12.5], p = 0.01).Conclusions:
The early alteration of brainstem reflexes measured by the BRASS score was not independently predictable in terms of mortality in the non-neurological ICU patients, admitted under sedation and mechanical ventilation.Trial registration ClinicalTrials.gov Identifier NCT03835091,Registered 8 February 2019 - prospectively registered, https//clinicaltrials.gov/ct2/show/NCT03835091.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
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Tronco Encefálico
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Estado Terminal
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Hipnóticos e Sedativos
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Unidades de Terapia Intensiva
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article