Opioid Prescribing in Opioid-Naïve and Opioid-Exposed Mechanically Ventilated Medically Critically Ill Patients

对未使用过阿片类药物和已使用过阿片类药物的机械通气重症患者进行阿片类药物处方

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Abstract

OBJECTIVE: Characterize opioid prescribing patterns in the ICU and post-hospital discharge in invasively mechanically ventilated (IMV) opioid-naïve and opioid-exposed patients. DESIGN: Single-center, retrospective cohort study. SETTING: Tertiary academic medical center. PATIENTS PARTICIPANTS: Patients requiring IMV admitted to the MICU. INTERVENTIONS: None. MAIN OUTCOMES MEASURES: Difference in opioid prescriptions at discharge from the hospital and opioid use during IMV between groups. RESULTS: A total of 85 patients were included, 60 (70.6%) were opioid-naïve and 25 (29.4%) were opioid-exposed prior to admission. Five (8.3%) opioid-naïve and 16 (64.0%) opioid-exposed were prescribed opioids on discharge (P < 0.001). Median morphine milligram equivalents (MME) per day during IMV did not differ between groups. CONCLUSIONS: Although opioid discharge prescribing was relatively uncommon among medical ICU patients who were opioid-naïve prior to admission, areas to evaluate and optimize opioid prescribing during IMV and at discharge were identified.

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