Assessing Sedation Practice in Critically Ill Patients Among ICU In TASH, A Prospective Observational Study
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Date
2025-12-07
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Addis Ababa University
Abstract
Background: Sedation is an Essential Component of Care for Mechanically Ventilated ICU Patients, Aimed at Ensuring Comfort, and Safety. Evidence-Based Guidelines Recommend Light, Protocolized Sedation with Routine Use of Validated Assessment Tools. However, Adherence to These Practices Remains Variable in Low-Resource Settings, Contributing to Suboptimal Outcomes.
Object: -This Study Evaluated Sedation Practices, Monitoring Patterns, and Associated Outcomes in an ICU Patient.
Methods: A Cross-Sectional Review of ICU Patients Receiving Mechanical Ventilation Was Conducted. Demographic Characteristics, Sedative Agents Used, Sedation Monitoring Methods, And Sedation-Related Outcomes were Analyzed. Findings were Interpreted in Relation to International Guidelines and Recent Literature on Protocolized Sedation Strategies.
Results: The ICU Cohort Consisted Predominantly of Young to Middle-Aged Adults (14–45 Years: 61.2%) and Males (63.9%). Respiratory Failure, ARDS, and Neurological Conditions were the Most Common Reasons for ICU Admission. Ketamine was the Most Frequently Used Sedative Agent (25%), Followed by Propofol (16.7%) And Ketofol (13.9%), with Doses Within Accepted Therapeutic Ranges. Continuous Infusions were Used in 36.1% of Cases, and Light Sedation Targets (RASS –2 To 0) Were Applied in 30.6% of patients. However, Substantial Gaps in Monitoring were Identified: Only 40.3% Had Documented Sedation Scale Assessments, and Daily Sedation Interruption Was Performed in Just 6.9%. Prolonged Mechanical Ventilation (≥3 Days in 86.1%), Extended ICU Stays, and High 30-Day Mortality (55.6%) were Observed. Delirium and Sedation-Related Complications were Rarely Documented, Likely Reflecting Under Assessment.
Conclusion: Sedation Practices in This ICU Setting Are Characterized by Acceptable Choice of Sedative Agents but Significant Deficiencies in Monitoring, Documentation, and Protocol Adherence. Limited use of Sedation Scales and Daily Interruption May Contribute to Prolonged Ventilation and poor Outcomes.
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Keywords
Sedation, Mechanical Ventilation, ICU, Ketamine, RASS, Protocolized Sedation, Resource Limited Settings