Effects Of Sedation And Analgesia Strategies Based On The ECASH Concept On Delirium In Patients With Mechanical Ventilation In ICU

ObjectiveTo investigate the influence of analgesic and sedative strategies based on the e CASH concept on delirium in ICU patients with mechanical ventilation,so as to provide reference for the clinical optimization of analgesic and sedative nursing plan for patients with mechanical ventilation,reduce the incidence of delirium and other complications and improve the prognosis of patients.MethodsA total of 96 mechanical ventilation patients admitted to the ICU of the second people’s hospital of wuxi,affiliated to nanjing medical university were selected as the research objects.According to the admission order,48 patients admitted to the ICU from January to December 2017 were set as the control group,and 48 patients admitted to the ICU from January to December 2018 were set as the observation group.The control group and dry observers were all given ICU routine nursing measures of mechanical ventilation: ICU basic care,daily awakening,management of analgesics and sedatives,early activities,etc.The intervention group implemented comfortable and superficial sedation management and nursing based on e CASH concept on the basis of ICU mechanical ventilation routine nursing.The delirium incidence,the dose of analgesics and sedatives,mechanical ventilation time,Sleep quality score,MRC score,ICU-AW incidence and ICU treatment time were compared between the two groups.Results1.The control group and observation group of patients with gender,age,acute physiology and chronic health rating system Ⅱ(APECH Ⅱ)score,BMI status has no obvious difference(P > 0.05),comparable between 2 groups.2.The delirium incidence in the observation group was 8.3% lower than that in the control group(22.9%),and the difference was statistically significant(P<0.05).Mechanical ventilation time in the observation group was 142.83±98.93 h,which was statistically significant compared with that in the control group(242.33±97.82h)(P<0.05).ICU treatment time in the observation group was8.92±5.35 d lower than that in the control group(14.10±5.52d),which was statistically significant(P<0.05).3.The MRC score of the observation group was 51.25±7.31 points higher than that of the control group(44.96±10.52 points),and the difference was statistically significant(x2/t=3.742,P < 0.01).ConclusionsThe comfortable analgesic and sedative nursing measures based on e CASH concept were implemented for ICU mechanical ventilation patients,it can reduce delirium and acquired weakness in ICU,shorten mechanical ventilation and ICU admission time,and promote prognosis and recovery of patients.