Physicians’ beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists; [Croyances et importance perçue par les médecins de l’agitation associée aux traumatismes crâniens chez la patientèle gravement malade : un sondage réalisé auprès d’intensivistes au Canada]

被引：0

作者：

Saavedra-Mitjans M. ^{[1
,2
]}

Frenette A.J. ^{[1
,2
,3
]}

McCredie V.A. ^{[4
,5
,6
]}

Burry L. ^{[7
,8
]}

Arbour C. ^{[2
,9
]}

Mehta S. ^{[4
,10
]}

Charbonney E. ^{[11
,12
,13
]}

Wang H.T. ^{[11
,12
,13
]}

Albert M. ^{[2
,11
,14
]}

Bernard F. ^{[2
,11
,14
]}

Williamson D. ^{[1
,2
,3
]}

机构：

[1] Faculty of Pharmacy, Université de Montréal, Montreal, QC

[2] Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montreal, QC

[3] Pharmacy Department, Hôpital du Sacré-Cœur de Montréal, Montreal, QC

[4] Department of Medicine, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON

[5] Department of Medicine, University Health Network and Sinai Health System, Toronto, ON

[6] Krembil Research Institute, Toronto, ON

[7] Department of Pharmacy, Mount Sinai Hospital, Toronto, ON

[8] Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON

[9] Faculty of Nursing, Université de Montréal, Montreal, QC

[10] Department of Medicine, Sinai Health, Toronto, ON

[11] Faculty of Medicine, Université de Montréal, Montreal, QC

[12] Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montreal, QC

[13] Research Centre, Centre Hospitalier de l’Université de Montréal, Montreal, QC

[14] Department of Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, QC

来源：

Canadian Journal of Anesthesia/Journal canadien d'anesthésie | 2024年 / 71卷 / 2期

关键词：

agitation; intensive care medicine; physicians; survey; traumatic brain injury;

D O I：

10.1007/s12630-023-02666-1

中图分类号：

学科分类号：

摘要：

Purpose: Agitation is a common behavioural problem following traumatic brain injury (TBI). Intensive care unit (ICU) physicians’ perspectives regarding TBI-associated agitation are unknown. Our objective was to describe physicians’ beliefs and perceived importance of TBI-associated agitation in critically ill patients. Methods: Following current standard guidance, we built an electronic, self-administrated, 42-item survey, pretested it for reliability and validity, and distributed it to 219 physicians working in 18 ICU level-1 trauma centres in Canada. We report the results using descriptive statistics. Results: The overall response rate was 93/219 (42%), and 76/93 (82%) respondents completed the full survey. Most respondents were men with ten or more years of experience. Respondents believed that pre-existing dementia (90%) and regular recreational drug use (86%) are risk factors for agitation. Concerning management, 91% believed that the use of physical restraints could worsen agitation, 90% believed that having family at the bedside reduces agitation, and 72% believed that alpha-2 adrenergic agonists are efficacious for managing TBI agitation. Variability was observed in beliefs on epidemiology, sex, gender, age, socioeconomic status, and other pharmacologic options. Respondents considered TBI agitation frequent enough to justify the implementation of management protocols (87%), perceived the current level of clinical evidence on TBI agitation management to be insufficient (84%), and expressed concerns about acute and long-term detrimental outcomes and burden to patients, health care professionals, and relatives (85%). Conclusion: Traumatic brain injury-associated agitation in critically ill patients was perceived as an important issue for most ICU physicians. Physicians agreed on multiple approaches to manage TBI-associated agitation although agreement on epidemiology and risk factors was variable. © Canadian Anesthesiologists' Society 2023.

引用

页码：264 / 273

页数：9