1
|
Riccardi A, Serra S, De Iaco F, Fabbri A, Shiffer D, Voza A. Uncovering the Benefits of the Ketamine-Dexmedetomidine Combination for Procedural Sedation during the Italian COVID-19 Pandemic. J Clin Med 2023; 12:jcm12093124. [PMID: 37176565 PMCID: PMC10179324 DOI: 10.3390/jcm12093124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/01/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
This retrospective observational study evaluated the safety and efficacy of the ketamine and dexmedetomidine combination (keta-dex) compared to ketamine or dexmedetomidine alone for sedation of patients with acute respiratory distress due to COVID-19 pneumonia who require non-invasive ventilation. The following factors were assessed: tolerance to the ventilation, sedation level on the Richmond Agitation-Sedation Scale (RASS), hemodynamic and saturation profile, adverse effects, and discontinuation or mortality during ventilation. The study included 66 patients who underwent sedation for non-invasive ventilation using keta-dex (KETA-DEX group, n = 22), ketamine (KET group, n = 22), or dexmedetomidine (DEX group, n = 22). The DEX group showed a slower sedation rate and a significant reduction in blood pressure compared to the KETA-DEX group (p < 0.05). An increase in blood pressure was recorded more frequently in the KET group. No reduction in oxygen saturation and no deaths were observed in any of the groups. None of the patients discontinued ventilation due to intolerance. The mean duration of sedation was 28.12 h. No cases of delirium were observed in any of the groups. Overall, keta-dex was associated with faster sedation rates and better hemodynamic profiles compared to dexmedetomidine alone. Keta-dex is effective and safe for sedation of uncooperative patients undergoing non-invasive ventilation.
Collapse
Affiliation(s)
| | - Sossio Serra
- Emergency Department, Maurizio Bufalini Hospital, 47522 Cesena, Italy
| | - Fabio De Iaco
- Emergency Department, Ospedale Maria Vittoria, 10144 Turin, Italy
| | - Andrea Fabbri
- Emergency Department, AUSL Romagna, Presidio Ospedaliero Morgagni-Pierantoni, 47121 Forlì, Italy
| | - Dana Shiffer
- Emergency Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
| | - Antonio Voza
- Emergency Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
| |
Collapse
|
2
|
Grandinetti P, Gooney M, Scheibein F, Testa R, Ruggieri G, Tondo P, Corona A, Boi G, Floris L, Profeta VF, Wells JSG, De Berardis D. Stress and Maladaptive Coping of Italians Health Care Professionals during the First Wave of the Pandemic. Brain Sci 2021; 11:brainsci11121586. [PMID: 34942888 PMCID: PMC8699311 DOI: 10.3390/brainsci11121586] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Stress during the pandemic has had an impact on the mental health of healthcare professionals (HCPs). However, little is known about coping and “maladaptive” coping behaviours of this population. This study investigates “maladaptive” coping behaviours and their correlation with stress, anxiety and insomnia of Italian HCPs during the pandemic. It reports on a cross-sectional, descriptive and correlational study based on a survey of 1955 Italian HCPs. Overall participants reported increases in cigarette smoking, time spent online and video playing. Overall reported alcohol consumption decreased but increased in those reporting drinking more than once a week. Those reporting starting smoking during the pandemic were found to have higher SAS and PSS scores. Those reporting being online for 3 or more hours were found to have higher ISS scores. Doctors who reported playing video games were found to have higher PSS, ISS and SAS scores whilst nurses who reported playing video games were found to have higher ISS scores. Doctors who reported playing for longer than one hour had higher PSS scores. Online behaviours may be a coping behaviour of HCPs affected by the pandemic. However, this is an underexplored area for the wellbeing of HCPs. These deficits need to be addressed going forward.
Collapse
Affiliation(s)
- Paolo Grandinetti
- Department of Territorial Assistance, ASL Teramo, 64100 Teramo, Italy; (P.G.); (G.R.); (P.T.)
| | - Martina Gooney
- School of Health Sciences, Waterford Institute of Technology, X91 K0EK Waterford, Ireland; (M.G.); (F.S.); (J.S.G.W.)
| | - Florian Scheibein
- School of Health Sciences, Waterford Institute of Technology, X91 K0EK Waterford, Ireland; (M.G.); (F.S.); (J.S.G.W.)
| | - Roberta Testa
- Department of Mental Health, ASL Teramo, 64100 Teramo, Italy; (R.T.); (V.F.P.)
| | - Gaetano Ruggieri
- Department of Territorial Assistance, ASL Teramo, 64100 Teramo, Italy; (P.G.); (G.R.); (P.T.)
| | - Paolo Tondo
- Department of Territorial Assistance, ASL Teramo, 64100 Teramo, Italy; (P.G.); (G.R.); (P.T.)
| | - Anastasia Corona
- Department of Mental Health and Addiction, ATTS Sardegna-Zona Sud, 09100 Cagliari, Italy; (A.C.); (G.B.); (L.F.)
| | - Graziella Boi
- Department of Mental Health and Addiction, ATTS Sardegna-Zona Sud, 09100 Cagliari, Italy; (A.C.); (G.B.); (L.F.)
| | - Luca Floris
- Department of Mental Health and Addiction, ATTS Sardegna-Zona Sud, 09100 Cagliari, Italy; (A.C.); (G.B.); (L.F.)
| | - Valerio F. Profeta
- Department of Mental Health, ASL Teramo, 64100 Teramo, Italy; (R.T.); (V.F.P.)
| | - John S. G. Wells
- School of Health Sciences, Waterford Institute of Technology, X91 K0EK Waterford, Ireland; (M.G.); (F.S.); (J.S.G.W.)
| | - Domenico De Berardis
- Department of Territorial Assistance, ASL Teramo, 64100 Teramo, Italy; (P.G.); (G.R.); (P.T.)
- Correspondence:
| |
Collapse
|