The Application of Different Sedation Protocols in ICU Patients With Severe Pneumonia

The study subjects were patients with severe pneumonia hospitalized in the Department of Respiratory and Critical Care Medicine at Xiangya Hospital, Central South University, from February 1, 2023 to December 31, 2024. Patients meeting all the following criteria were enrolled: (1) diagnosed with severe pneumonia; (2) receiving invasive mechanical ventilation and requiring continuous sedation treatment; (3) age ≥ 18 years. Patients were excluded if they met any of the following conditions: (1) allergic to routine sedative or analgesic medications; (2) had not undergone sedation-agitation assessment; (3) transferred to another hospital during treatment; (4) withdrew from active treatment or were discharged from the ICU within 72 hours after initiation of sedation. Data on patient demographics, laboratory tests, chest imaging, respiratory support methods, severity of illness assessments, sedative medication usage, and clinical outcomes were collected. The duration of mechanical ventilation under different sedation regimens in real-world settings was compared, and the correlation between sedation success rates, hemodynamic changes, and clinical outcomes in patients with severe pneumonia was evaluated and compared.

Inclusion criteria

(1)From February 1, 2023, to December 31, 2024, diagnosed with severe pneumonia in the Respiratory Intensive Care Unit of Xiangya Hospital, Central South University. The diagnosis of severe pneumonia is based on meeting at least one major criterion or three or more minor criteria:

• Major criteria:

①Infectious shock requiring vasopressor therapy despite adequate fluid resuscitation;

②Respiratory failure requiring tracheal intubation or mechanical ventilation.

• Minor criteria:

• Respiratory rate ≥ 30 breaths/min;

• Oxygenation index (PaO2/FiO2) ≤ 250; ③Involvement of multiple lobes;

• Altered mental status and/or disorientation; ⑤Blood urea nitrogen ≥ 20 mg/dl (7.14 mmol/L);

⑥Systolic blood pressure < 90 mmHg requiring aggressive fluid resuscitation. (2)Patients receiving invasive mechanical ventilation who require continuous sedation treatment.

(3)Age ≥ 18 years.

Exclusion criteria

• Allergic to routine sedative or analgesic medications.
• Patients who have not undergone sedation-agitation assessment.
• Patients transferred to another hospital during treatment.
• Patients who withdrew from active treatment or were discharged from the ICU within 72 hours after initiation of sedation.