| Objectives To compare the Richmond Agitation-sedation scores(Richmond Agitation Sedation Scale,RASS)and SAS sedation scores(sedation-agitation scale,SAS)apply effect and to discusses the two score the curative effect of patients with severe pneumonia in ICU mechanical ventilation.Methods A prospective randomized controlled study was conducted.90 cases patients who were admitted to the department of critical care from November 2018 to September 2019 affiliated hospital of north china university of science and technology and were diagnosed as severe pneunonia and required trachdal intubation mechanical ventilation were selected.According to the random number sequence,all the patients were divided into RASS and SAS group.The selected patients were routinely treated with the Early goal-directed Sedation(EGDS)concept for analgesia and sedation.RASS and SAS ideal sedation score were used to guide patients in sedation treatment.And then the effect of sedative,respiratory mechanics index,the dose of sedatives,the incidence of adverse drug reactions,duration of invasive mechanical ventilation,duration of spontaneous respiratory recovery,duration of ICU stay,incidence of adverse events and in the two groups were compared and analyzed.Results A total of 90 patients with clinical mechanical ventilation were enrolled in this study.45 patients in RASS group and 45 patients in SAS group were enrolled.1 There was no significant difference between the two groups in general data such as gender,age,Body Mass Index(BMI),acute physiology and chronic health status score II(APACHE II),basic diseases and so on(P>0.05).2 Compared with the RASS group,the heart rate and average arterial pressure of the SAS group were significantly reduced after 4h of sedation,with statistically significant differences(P<0.05).3 There was no significant difference in Pa O2/Fi O2,Pa CO2 and RR between the two groups(P>0.05).4 The indexes of PIP,Raw and Cdyn in the RASS group and the SAS group were no significant difference on 1d(P<0.05).5 There were differences in respiratory mechanical parameters between the two groups on 3d,5d and 7d(P<0.05),the improvement of respiratory mechanical parameters was more obvious in the RASS group,and the decrease trend of PIP and Raw and increase trend of Cdyn were observed in the RASS group.6 The duration of invasive mechanical ventilation,duration of ICU stay,incidence of adverse events in the RASS group were significantly shorter than the SAS group(P<0.05).There was no significant difference between the two groups in duration of spontaneous respiratory recovery(P>0.05).7 The dose of sedatives and analgesic in the SAS group and the incidence of adverse drug reactions was significantly higher than the RASS group(P<0.05).Conclusions Among the sedation scale used on patients with severe pneumonia receiving mechanical ventilation,when conducting sedation treatment based on EGDS,the utilization of RASS for sedation treatment can remarkably reduce the duration of invasive mechanical ventilation,length of stay in ICU as well as the occurrence of adverse events.It can help the patients reach a sedated state conducive to remission by administrating a smaller dosage of sedatives,reduce the occurrence of adverse events of drugs,and improve the patients’ clinical prognosis.Therefore,it deserves further research and application in future clinical work.Figure 7;Table 11;Reference 108... |
