Introduction: Sedation management with hepatic and renal dysfunction have been associated with negative outcomes in critically ill ICU patients. This study examines the impact of sedation practices and management; and hepatic and renal function data on critically ill patients’ short and long-term outcomes.
Methods: Sedation dosing, hepatic and renal function data were collected from ICU flow charts of 33 patients who had been admitted to ICU and sedated for up to five days between 1st July 2015 and 31st July 2016. The five-day period provided adequate time to establish management of sedation, hepatic and renal function data in relation to patient outcome. Invitation to participate in an open-ended interview, consent forms including the Hospital Anxiety and Depression Scale (HADS) with self-addressed envelopes were sent to all 33 participants 36 months post ICU discharge.
Results: Ten (n=10) participants completed the Hospital Anxiety and Depression Scale (HADS) and two participants were interviewed 36 months post ICU. Patients with high sedation dosing, elevated hepatic and renal function data had a longer ventilator, ICU and hospital length of stay (LOS) and high HADS scores. The only patient who was interviewed, reported poor functional capacity and cognitive decline. His wife reported changed lived experience in which she longed for her pre ICU husband to return.
Conclusion: Sedation dosing; hepatic and renal dysfunction are associated with negative short and long-term outcomes for ICU patients.