Use of intravenous infusion sedation among mechanically ventilated patients in the United States*
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
OBJECTIVES: Many studies compare the efficacy of different forms of intravenous infusion sedation for critically ill patients, but little is known about the actual use of these medications. We sought to describe current use of intravenous infusion sedation in mechanically ventilated patients in U.S. intensive care units. DESIGN: Retrospective cohort study of intravenous infusion sedation among mechanically ventilated patients. Intravenous sedatives examined included benzodiazepines (midazolam and lorazepam), propofol, and dexmedetomidine. Use was defined as having received an intravenous infusion for any time period during the stay in intensive care. SETTING: One hundred seventy-four intensive care units contributing data to Project IMPACT from 2001 through 2007. PATIENTS: All patients who received mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 109,671 mechanically ventilated patients, 56,443 (51.5%, 95% confidence interval 51.2-51.8) received one or more intravenous infusion sedatives. Sedative use increased over time, from 39.7% (38.7-40.6) of patients in 2001 to 66.7% (65.7-67.7) in 2007 (p < .001). Most patients who received intravenous infusion sedation received propofol (82.2%, 81.9-82.5) vs. benzodiazepines (31.1%, 30.7-31.5) or dexmedetomidine (4.0%, 3.8-4.2). Of the patients, 66.2% (65.8-66.6) received only propofol, and 16.2% (15.9-16.5) only benzodiazepines. Among patients mechanically ventilated >96 hrs, propofol infusions were more common. Intravenous infusion narcotics (fentanyl, morphine, or hydromorphone) were used more frequently among patients who received benzodiazepines (70.1%, 69.1-71.0) compared with propofol (23.9%, 23.5-24.3), p < .001. CONCLUSIONS: The percentage of mechanically ventilated patients receiving intravenous infusion sedation has increased over time. Sedation with an infusion of propofol was much more common than with benzodiazepines or dexmedetomidine, even for patients mechanically ventilated beyond 96 hrs.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it