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Deeper sedation levels within the first 48 hours of intensive care unit admission have been associated with longer duration of mechanical ventilation and increased mortality. Unclear, however, is whether deeper levels of sedation in intubated emergency department (ED) patients has the same effects on mortality.
These authors analyzed a prospective observational cohort of 414 adult patients who were mechanically ventilated in a single ED. Patients were excluded if they were intubated for cardiac arrest or neurologic injury since they frequently have depressed mental status. Sedation depth was measured with the Richmond Agitation-Sedation Scale
Fentanyl (86% of patients), midazolam (61%), and propofol (47%) were used most often for ED sedation,…