Association between respiratory drive and depth of sedation in subjects under invasive mechanical ventilation: an observational study
Abstract
Objective: The objective of this study is to determine whether there is an association between respiratory drive, assessed through P0.1, and depth of sedation, measured through the Richmond agitation-sedation scale (RASS), in adult subjects undergoing invasive mechanical ventilation and admitted to the intensive care unit of Hospital de Clínicas José de San Martín (HCJSM) in Buenos Aires. As a secondary objective, we aim to analyze the behavior of variables that may have an impact on respiratory drive.
Materials and method: An observational study was conducted at a university hospital in the Autonomous City of Buenos Aires, between April 1, 2023, and May 28, 2023. The analyzed variables included P0.1, RASS, pain, delirium, exposure to analgesics and sedatives, acid-base status, pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2), sepsis-related organ failure assessment (SOFA), and body mass index (BMI).
Results: A total of 71 measurements were collected from 33 subjects. The median P0.1 was 0.13 cmH20 (0-0.97). In the univariate analysis, an inversely proportional association was found between P0.1 and RASS score (β=-0.4068 and p=0.0435). The results of the multivariate analysis showed no association between P0.1 and any of the considered variables when adjusted for each other.
Conclusion: In this study, we found an association between P0.1 and RASS score, along with an independent association between P0.1 and exposure to the combination of analgesia and sedation. However, when adjusting these variables in the multivariate analysis, no association was found.
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