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To address these challenges, the Pain, Agitation, Delirium, and Sleep Deprivation (PADS) protocol was developed, aiming to mitigate mortality and improve clinical outcomes. This study focuses on assessing the protocol's impact using a robust before\u2010and\u2010after study design in the medical and surgical intensive care units (ICUs) at Ramathibodi Hospital. Using an observational approach, this study compares clinical outcomes before and after implementing the PADS protocol in the ICUs. Two patient cohorts were identified: the \u201cbefore\u201d group, comprising 254 patients with retrospective data collected between May 2018 and September 2019, and the \u201cafter\u201d group, consisting of 255 patients for whom prospective data was collected from May to September 2020. Analysis reveals improvements in the after group. Specifically, there was a significant increase in 14\u2010day ICU\u2010free days (9.95\u2009days vs. 10.40\u2009days, <jats:italic>p<\/jats:italic> value\u2009=\u20090.014), a decrease in delirium incidence (18.1% vs. 16.1%, <jats:italic>p<\/jats:italic> value &lt;\u20090.001), and a significant reduction in benzodiazepine usage (38.6% vs. 24.6%, <jats:italic>p<\/jats:italic> value\u2009=\u20090.001) within the after group. This study emphasizes the protocol's potential to improve patient care and highlights its significance in the ICU context.<\/jats:p>","DOI":"10.1111\/cts.13739","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T14:34:56Z","timestamp":1709217296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Implementing pain, agitation, delirium, and sleep deprivation protocol in critically ill patients: A pilot study on pharmacological interventions"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8179-5711","authenticated-orcid":false,"given":"Punchika","family":"Luetrakool","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University  Bangkok 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