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Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
Acute Crit Care. 2023;38(1):149-149.   Published online February 27, 2023
DOI: https://doi.org/10.4266/acc.2022.00094.e1
Corrects: Acute Crit Care 2022;37(1):1
  • 1,948 View
  • 225 Download
  • 1 Crossref
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Citations to this article as recorded by  
  • Can we make a safer sedation?
    M.S. Danilov, I.S. Simutis, A.S. Korotaev, D.S. Salygina, V.A. Ratnikov, V.A. Kashchenko
    Anesteziologiya i reanimatologiya.2023; (4): 49.     CrossRef
Guideline
Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
Acute Crit Care. 2022;37(1):1-25.   Published online February 28, 2022
DOI: https://doi.org/10.4266/acc.2022.00094
Correction in: Acute Crit Care 2023;38(1):149
  • 18,073 View
  • 1,770 Download
  • 15 Web of Science
  • 23 Crossref
AbstractAbstract PDF
We revised and expanded the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).” We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding. The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.

Citations

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  • Potentially inappropriate medications with older people in intensive care and associated factors: a historic cohort study
    Karina Sichieri, Danilo Donizetti Trevisan, Ricardo Luís Barbosa, Silvia Regina Secoli
    Sao Paulo Medical Journal.2024;[Epub]     CrossRef
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  • Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality
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    Hyo-Geun Song, Duckhee Chae, Sung-Hee Yoo
    Korean Journal of Adult Nursing.2023; 35(4): 379.     CrossRef
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    Heidi Engel
    Critical Care Medicine.2022; 50(11): 1665.     CrossRef
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    Jiyeon Kang, Yongbin Kwon
    Journal of Korean Critical Care Nursing.2022; 15(3): 115.     CrossRef
Original Article
Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards
Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
Acute Crit Care. 2019;34(4):246-254.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00668
  • 6,304 View
  • 198 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

Citations

Citations to this article as recorded by  
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ACC : Acute and Critical Care