{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T17:56:40Z","timestamp":1772819800272,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Lighter sedation targets over the past decade have resulted in improved outcomes for critically ill populations. Although guidelines exist for the general ICU population, these recommendations often exclude the burn population. The purpose of this study is to assess the impact of the initial continuous sedative on coma- and delirium-free days in critically ill patients with burns. This retrospective cohort study evaluated adult patients admitted to a burn intensive care unit at an academic medical center between January 2010 and September 2019. Patients were enrolled into 3 groups based on the depth of initial continuous sedation received (deep, light, or analgosedation). Intubated patients were randomly assessed for inclusion from the National V6 Burn Registry. Patients were included if they received a continuous sedative infusion for at least 48 h. A total of 107 patients were included in the study with 36, 41, and 30 patients receiving deep, light, and analgosedation, respectively. The primary outcome of coma- and delirium-free days was significantly different between sedation types with the most days free in analgosedation and the fewest in deep sedation (8 versus 3 days; P = 0.024). The composite primary outcome was divided into secondary outcomes of coma-free days and delirium-free days, with coma-free days being different (P = 0.00008). Other secondary outcomes of length of stay in the intensive care unit and hospital, time on mechanical ventilation, and survival to discharge were not statistically significant; however, a trend toward higher mortality in deep sedation was noted.<\/jats:p>","DOI":"10.1093\/jbcr\/irad164","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T01:29:52Z","timestamp":1698197392000},"page":"410-415","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Continuous Sedatives in the Burn ICU on Delirium and Coma"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8867-1535","authenticated-orcid":false,"given":"Jessica A","family":"Falksen","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services, University of California Davis Health , 2315 Stockton Blvd, Sacramento, CA 95817 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-4229","authenticated-orcid":false,"given":"Sierra R","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, University of California Davis Health , 2315 Stockton Blvd, Sacramento, CA 95817 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8388-3571","authenticated-orcid":false,"given":"Jin A","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, University of California Davis Health , 2315 Stockton Blvd, Sacramento, CA 95817 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"2024030419494290100_CIT0001","first-page":"27","article-title":"Sedation, analgesia, and delirium in the critically ill patient","volume-title":"J Pharm 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180-day mortality: a multinational prospective longitudinal cohort study","volume-title":"Crit Care Med","author":"Shehabi","year":"2018"},{"key":"2024030419494290100_CIT0006","first-page":"2427","article-title":"Analgo-sedation of patients with burns outside the operating room","volume-title":"Drugs","author":"Gregoretti","year":"2008"},{"key":"2024030419494290100_CIT0007","first-page":"535","article-title":"Sedation and pain management in burn patients","volume-title":"Clin Plast Surg","author":"Griggs","year":"2017"},{"issue":"2","key":"2024030419494290100_CIT0008","first-page":"135","article-title":"Analgesia, sedation and arousal status in burn patients: the gap between recommendations and current practices","volume":"30","author":"Lavrentieva","year":"2017","journal-title":"Ann Burns Fire Disasters"},{"key":"2024030419494290100_CIT0009","first-page":"533","article-title":"Burn injury pain: the continuing challenge","volume-title":"J Pain","author":"Summer","year":"2007"},{"key":"2024030419494290100_CIT0010","first-page":"387","article-title":"Pathophysiologic response to severe burn injury","volume-title":"Ann Surg","author":"Jeschke","year":"2008"},{"key":"2024030419494290100_CIT0011","first-page":"241","article-title":"Clinical review: the critical care management of the burn patient","volume-title":"Crit Care","author":"Snell","year":"2013"},{"key":"2024030419494290100_CIT0012","first-page":"1753","article-title":"Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit","volume-title":"JAMA","author":"Ely","year":"2004"},{"key":"2024030419494290100_CIT0013","first-page":"706","article-title":"Prevalence and risk factors for development of delirium in burn intensive care unit patients","volume-title":"J Burn Care Res","author":"Agarwal","year":"2010"},{"key":"2024030419494290100_CIT0014","first-page":"2130","article-title":"Benzodiazepine-associated delirium in critically ill adults","volume-title":"Intensive Care Med","author":"Zaal","year":"2015"},{"key":"2024030419494290100_CIT0015","first-page":"1502","article-title":"Dexmedetomidine use and mortality in mechanically ventilated patients with severe burns: a cohort study using a national inpatient database in Japan","volume-title":"Burns","author":"Enomoto","year":"2021"},{"key":"2024030419494290100_CIT0016","first-page":"1310","article-title":"Feasibility and impact of the implementation of a clinical scale-based sedation-analgesia protocol in severe burn patients undergoing mechanical ventilation. A before-after bi-center study","volume-title":"Burns","author":"Cinotti","year":"2020"},{"key":"2024030419494290100_CIT0017","first-page":"e31813","article-title":"Sedation with dexmedetomidine in critically ill burn patients reduced delirium during weaning from mechanical ventilation","volume-title":"Cureus","author":"Stangaciu","year":"2022"},{"key":"2024030419494290100_CIT0018","first-page":"625","article-title":"A meta-analysis of analgesic and sedative effects of dexmedetomidine in burn patients","volume-title":"Burns","author":"Asmussen","year":"2013"},{"key":"2024030419494290100_CIT0019","first-page":"1776","article-title":"Efficacy of dexmedetomidine in reducing post-operative pain and improving the quality of recovery in patients with burn wounds undergoing tangential excision skin grafting","volume-title":"Exp Ther Med","author":"Jiang","year":"2019"},{"key":"2024030419494290100_CIT0020","first-page":"151","article-title":"Comparing the effect of gabapentin, ketamine, dexmedetomidine, and entonox on pain control in burn wound dressing","volume-title":"J Burn Care Res","author":"Chaghazardi","year":"2020"},{"key":"2024030419494290100_CIT0021","first-page":"1146","article-title":"Impact of opioid-minimizing pain protocols after burn injury","volume-title":"J Burn Care Res","author":"Donthula","year":"2021"},{"key":"2024030419494290100_CIT0022","first-page":"724","article-title":"Early intensive care sedation predicts long-term mortality in ventilated critically ill patients","volume-title":"Am J Respir Crit Care Med","author":"Shehabi","year":"2012"},{"key":"2024030419494290100_CIT0023","first-page":"R156","article-title":"Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study","volume-title":"Crit Care","author":"Tanaka","year":"2014"},{"key":"2024030419494290100_CIT0024","first-page":"225","article-title":"The ABCDEF bundle in critical care","volume-title":"Crit Care Clin","author":"Marra","year":"2017"},{"key":"2024030419494290100_CIT0025","first-page":"515","article-title":"Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial","volume-title":"Lancet Respir Med","author":"Page","year":"2013"},{"key":"2024030419494290100_CIT0026","first-page":"2506","article-title":"Haloperidol and ziprasidone for treatment of delirium in critical illness","volume-title":"N Engl J Med","author":"Girard","year":"2018"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/irad164\/52789352\/irad164.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/45\/2\/410\/56828192\/irad164.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/45\/2\/410\/56828192\/irad164.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T19:50:15Z","timestamp":1709581815000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/45\/2\/410\/7329324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,24]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,10,24]]},"published-print":{"date-parts":[[2024,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/irad164","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,3,1]]},"published":{"date-parts":[[2023,10,24]]}}}