Impact of restarting home neuropsychiatric medications on sedation outcomes in medical intensive care unit patients

Mary K. La, Melissa L. Thompson Bastin, Jenee T. Gisewhite, Carrie A. Johnson, Alexander H. Flannery

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Purpose This single-center, retrospective cohort study investigated the effects of timing of initiating home neuropsychiatric medications (NPMs) on sedation-related outcomes. Materials and methods Subjects included adult medical intensive care unit (MICU) patients who had an NPM on their admission medication list; intubated before or on arrival to the intensive care unit (ICU); and were on benzodiazepine-based sedation. The intervention assessed was the timing of the initiation of home NPMs: early (≤ 5 days) vs. late (> 5 days) into the ICU stay. Results There were 56 and 53 patients in the early and late restart groups, respectively. Early cohort patients maintained a median daily RASS of − 1.5, while late cohort patients had a median daily RASS of − 2.0 (p = 0.02). The effect was driven by the subgroup of patients on home anti-depressant therapy who were restarted early on these agents. The early restart group had a higher percentage of days with RASS scores within goal (p = 0.01) and less delirium (p = 0.02). Early restarting of home NPMs was associated with a non-significant decrease in ventilator days compared with late restarting (p = 0.11). Conclusions Restarting home NPMs was associated with lighter sedation levels and less delirium.

Original languageEnglish
Pages (from-to)102-107
Number of pages6
JournalJournal of Critical Care
Volume43
DOIs
StatePublished - Feb 2018

Bibliographical note

Publisher Copyright:
© 2017 Elsevier Inc.

Keywords

  • Antidepressants
  • Antipsychotics
  • Benzodiazepines
  • Gabapentinoids
  • Medication reconciliation
  • Sedation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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