Organizational factors associated with target sedation on the first 48 h of mechanical ventilation: an analysis of checklist-ICU database View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Antonio Paulo Nassar, Fernando G. Zampieri, Jorge I. Salluh, Fernando A. Bozza, Flávia Ribeiro Machado, Helio Penna Guimarães, Lucas P. Damiani, Alexandre Biasi Cavalcanti

ABSTRACT

BACKGROUND: Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role on adherence to light sedation levels. We aimed to identify organizational factors associated with a moderate to light sedation target on the first 48 h of mechanical ventilation, as well as the association between early achievement of within-target sedation and mortality. METHODS: This study is a secondary analysis of a multicenter two-phase study (prospective cohort followed by a cluster-randomized controlled trial) performed in 118 Brazilian ICUs. We included all critically ill patients who were on mechanical ventilation 48 h after ICU admission. A moderate to light level of sedation or being alert and calm (i.e., the Richmond Agitation-Sedation Scale of - 3 to 0) was the target for all patients on mechanical ventilation during the study period. We collected data on the type of hospital (public, private, profit and private, nonprofit), hospital teaching status, nursing and physician staffing, and presence of sedation, analgesia, and weaning protocols. We used multivariate random-effects regression with ICU and study phase as random-effects and correction for patients' Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment. We also performed a mediation analysis to explore whether sedation level was just a mediator of the association between organizational factors and mortality. RESULTS: We included 5719 patients. Only 1710 (29.9%) were on target sedation levels on day 2. Board-certified intensivists on the morning and afternoon shifts were associated with an adequate sedation level on day 2 (OR = 2.43; CI 95%, 1.09-5.38). Target sedation levels were associated with reduced hospital mortality (OR = 0.63; CI 95%, 0.55-0.72). Mediation analysis also suggested such an association, but did not suggest a relationship between the physician staffing model and hospital mortality. CONCLUSIONS: Board-certified intensivists on morning and afternoon shifts were associated with an increased number of patients achieving lighter sedation goals. These findings reinforce the importance of organizational factors, such as intensivists' presence, as a modifiable quality improvement target. More... »

PAGES

34

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13054-019-2323-y

DOI

http://dx.doi.org/10.1186/s13054-019-2323-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111765566

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30696474


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "AC Camargo Hospital", 
          "id": "https://www.grid.ac/institutes/grid.413320.7", 
          "name": [
            "Intensive Care Unit and Postgraduate Program, A.C. Camargo Cancer Center, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Nassar", 
        "givenName": "Antonio Paulo", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Hospital Alem\u00e3o Oswaldo Cruz", 
          "id": "https://www.grid.ac/institutes/grid.414358.f", 
          "name": [
            "Research Institute, HCor-Hospital do Cora\u00e7\u00e3o, S\u00e3o Paulo, Brazil", 
            "Hospital Alem\u00e3o Oswaldo Cruz, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Zampieri", 
        "givenName": "Fernando G.", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Federal University of Rio de Janeiro", 
          "id": "https://www.grid.ac/institutes/grid.8536.8", 
          "name": [
            "Graduate Program in Translational Medicine and Department of Critical Care, D\u2019Or Institute for Research and Education, Rio De Janeiro, Brazil", 
            "Programa de P\u00f3s-Gradua\u00e7\u00e3o em Clinica m\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Salluh", 
        "givenName": "Jorge I.", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Oswaldo Cruz Foundation", 
          "id": "https://www.grid.ac/institutes/grid.418068.3", 
          "name": [
            "Instituto Nacional de Infectologia Evandro Chagas, Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ), Instituto D\u2019Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Bozza", 
        "givenName": "Fernando A.", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Federal University of Sao Paulo", 
          "id": "https://www.grid.ac/institutes/grid.411249.b", 
          "name": [
            "Anesthesiology, Pain and Intensive Care Department, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Machado", 
        "givenName": "Fl\u00e1via Ribeiro", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Federal University of Sao Paulo", 
          "id": "https://www.grid.ac/institutes/grid.411249.b", 
          "name": [
            "Research Institute, HCor-Hospital do Cora\u00e7\u00e3o, S\u00e3o Paulo, Brazil", 
            "Federal univeristy of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Guimar\u00e3es", 
        "givenName": "Helio Penna", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Hospital do Cora\u00e7\u00e3o", 
          "id": "https://www.grid.ac/institutes/grid.477370.0", 
          "name": [
            "Research Institute, HCor-Hospital do Cora\u00e7\u00e3o, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Damiani", 
        "givenName": "Lucas P.", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Hospital do Cora\u00e7\u00e3o", 
          "id": "https://www.grid.ac/institutes/grid.477370.0", 
          "name": [
            "Research Institute, HCor-Hospital do Cora\u00e7\u00e3o, S\u00e3o Paulo, Brazil"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Cavalcanti", 
        "givenName": "Alexandre Biasi", 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "https://doi.org/10.1097/ccm.0b013e318168f82d", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1002483372"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0b013e318168f82d", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1002483372"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2016.0154", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1003581306"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/cc12594", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1010078566", 
          "https://doi.org/10.1186/cc12594"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-015-4076-7", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1014364517", 
          "https://doi.org/10.1007/s00134-015-4076-7"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000000754", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018947403"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000000754", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018947403"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-013-2830-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1021295774", 
          "https://doi.org/10.1007/s00134-013-2830-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00134-013-2830-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1021295774", 
          "https://doi.org/10.1007/s00134-013-2830-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/01.ccm.0000300275.63811.b3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1021776492"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/01.ccm.0000300275.63811.b3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1021776492"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.mayocp.2015.02.016", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026343381"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s13012-014-0190-0", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026539415", 
          "https://doi.org/10.1186/s13012-014-0190-0"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s13012-014-0190-0", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026539415", 
          "https://doi.org/10.1186/s13012-014-0190-0"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/archinternmed.2009.521", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1032102987"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2014.18399", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1035391523"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000001854", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1039287789"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000001854", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1039287789"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1164/rccm.201203-0522oc", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041214075"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s13054-015-0929-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041903373", 
          "https://doi.org/10.1186/s13054-015-0929-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s13054-015-0929-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041903373", 
          "https://doi.org/10.1186/s13054-015-0929-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s13054-015-0929-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041903373", 
          "https://doi.org/10.1186/s13054-015-0929-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2012.13872", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1042399008"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0b013e318292313a", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1042844683"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0b013e318292313a", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1042844683"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1056/nejm200005183422002", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1051418418"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1378/chest.114.2.541", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1051995437"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2013.5154", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1052797121"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1345/aph.1r037", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1053147537"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1345/aph.1r037", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1053147537"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1080/01621459.1992.10475190", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1058304219"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jamainternmed.2016.8457", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1074216745"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jamainternmed.2016.8457", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1074216745"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1077693076", 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/0310057x0803600423", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1077693076"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/0310057x0803600423", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1077693076"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/0310057x0803600423", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1077693076"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002373", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1084764272"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002373", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1084764272"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.chest.2017.03.054", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1085038954"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002413", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1085065216"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002413", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1085065216"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.chest.2017.05.041", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1086112046"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/s2213-2600(17)30304-1", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1091845886"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002885", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1099645802"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002885", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1099645802"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000002885", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1099645802"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000003071", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101323702"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1097/ccm.0000000000003071", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101323702"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/1062860618766614", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101849284"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/1062860618766614", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101849284"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/1062860618766614", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1101849284"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2018.9183", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1105804017"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2019-12", 
    "datePublishedReg": "2019-12-01", 
    "description": "BACKGROUND: Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role on adherence to light sedation levels. We aimed to identify organizational factors associated with a moderate to light sedation target on the first 48\u2009h of mechanical ventilation, as well as the association between early achievement of within-target sedation and mortality.\nMETHODS: This study is a secondary analysis of a multicenter two-phase study (prospective cohort followed by a cluster-randomized controlled trial) performed in 118 Brazilian ICUs. We included all critically ill patients who were on mechanical ventilation 48\u2009h after ICU admission. A moderate to light level of sedation or being alert and calm (i.e., the Richmond Agitation-Sedation Scale of -\u20093 to 0) was the target for all patients on mechanical ventilation during the study period. We collected data on the type of hospital (public, private, profit and private, nonprofit), hospital teaching status, nursing and physician staffing, and presence of sedation, analgesia, and weaning protocols. We used multivariate random-effects regression with ICU and study phase as random-effects and correction for patients' Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment. We also performed a mediation analysis to explore whether sedation level was just a mediator of the association between organizational factors and mortality.\nRESULTS: We included 5719 patients. Only 1710 (29.9%) were on target sedation levels on day 2. Board-certified intensivists on the morning and afternoon shifts were associated with an adequate sedation level on day 2 (OR\u2009=\u20092.43; CI 95%, 1.09-5.38). Target sedation levels were associated with reduced hospital mortality (OR\u2009=\u20090.63; CI 95%, 0.55-0.72). Mediation analysis also suggested such an association, but did not suggest a relationship between the physician staffing model and hospital mortality.\nCONCLUSIONS: Board-certified intensivists on morning and afternoon shifts were associated with an increased number of patients achieving lighter sedation goals. These findings reinforce the importance of organizational factors, such as intensivists' presence, as a modifiable quality improvement target.", 
    "genre": "research_article", 
    "id": "sg:pub.10.1186/s13054-019-2323-y", 
    "inLanguage": [
      "en"
    ], 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1117766", 
        "issn": [
          "1364-8535", 
          "1466-609X"
        ], 
        "name": "Critical Care", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "23"
      }
    ], 
    "name": "Organizational factors associated with target sedation on the first 48 h of mechanical ventilation: an analysis of checklist-ICU database", 
    "pagination": "34", 
    "productId": [
      {
        "name": "readcube_id", 
        "type": "PropertyValue", 
        "value": [
          "9e94e7d3feed95c9598636676e8431b4991921492af4ea02b2700c6ca9609009"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "30696474"
        ]
      }, 
      {
        "name": "nlm_unique_id", 
        "type": "PropertyValue", 
        "value": [
          "9801902"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1186/s13054-019-2323-y"
        ]
      }, 
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1111765566"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1186/s13054-019-2323-y", 
      "https://app.dimensions.ai/details/publication/pub.1111765566"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2019-04-11T09:00", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000329_0000000329/records_74683_00000000.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://link.springer.com/10.1186%2Fs13054-019-2323-y"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s13054-019-2323-y'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s13054-019-2323-y'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s13054-019-2323-y'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s13054-019-2323-y'


 

This table displays all metadata directly associated to this object as RDF triples.

232 TRIPLES      21 PREDICATES      62 URIs      21 LITERALS      9 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1186/s13054-019-2323-y schema:about anzsrc-for:11
2 anzsrc-for:1103
3 schema:author N0ee13ff3667047a2bf5f198f341588de
4 schema:citation sg:pub.10.1007/s00134-013-2830-2
5 sg:pub.10.1007/s00134-015-4076-7
6 sg:pub.10.1186/cc12594
7 sg:pub.10.1186/s13012-014-0190-0
8 sg:pub.10.1186/s13054-015-0929-2
9 https://app.dimensions.ai/details/publication/pub.1077693076
10 https://doi.org/10.1001/archinternmed.2009.521
11 https://doi.org/10.1001/jama.2012.13872
12 https://doi.org/10.1001/jama.2013.5154
13 https://doi.org/10.1001/jama.2014.18399
14 https://doi.org/10.1001/jama.2016.0154
15 https://doi.org/10.1001/jama.2018.9183
16 https://doi.org/10.1001/jamainternmed.2016.8457
17 https://doi.org/10.1016/j.chest.2017.03.054
18 https://doi.org/10.1016/j.chest.2017.05.041
19 https://doi.org/10.1016/j.mayocp.2015.02.016
20 https://doi.org/10.1016/s2213-2600(17)30304-1
21 https://doi.org/10.1056/nejm200005183422002
22 https://doi.org/10.1080/01621459.1992.10475190
23 https://doi.org/10.1097/01.ccm.0000300275.63811.b3
24 https://doi.org/10.1097/ccm.0000000000000754
25 https://doi.org/10.1097/ccm.0000000000001854
26 https://doi.org/10.1097/ccm.0000000000002373
27 https://doi.org/10.1097/ccm.0000000000002413
28 https://doi.org/10.1097/ccm.0000000000002885
29 https://doi.org/10.1097/ccm.0000000000003071
30 https://doi.org/10.1097/ccm.0b013e318168f82d
31 https://doi.org/10.1097/ccm.0b013e318292313a
32 https://doi.org/10.1164/rccm.201203-0522oc
33 https://doi.org/10.1177/0310057x0803600423
34 https://doi.org/10.1177/1062860618766614
35 https://doi.org/10.1345/aph.1r037
36 https://doi.org/10.1378/chest.114.2.541
37 schema:datePublished 2019-12
38 schema:datePublishedReg 2019-12-01
39 schema:description BACKGROUND: Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role on adherence to light sedation levels. We aimed to identify organizational factors associated with a moderate to light sedation target on the first 48 h of mechanical ventilation, as well as the association between early achievement of within-target sedation and mortality. METHODS: This study is a secondary analysis of a multicenter two-phase study (prospective cohort followed by a cluster-randomized controlled trial) performed in 118 Brazilian ICUs. We included all critically ill patients who were on mechanical ventilation 48 h after ICU admission. A moderate to light level of sedation or being alert and calm (i.e., the Richmond Agitation-Sedation Scale of - 3 to 0) was the target for all patients on mechanical ventilation during the study period. We collected data on the type of hospital (public, private, profit and private, nonprofit), hospital teaching status, nursing and physician staffing, and presence of sedation, analgesia, and weaning protocols. We used multivariate random-effects regression with ICU and study phase as random-effects and correction for patients' Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment. We also performed a mediation analysis to explore whether sedation level was just a mediator of the association between organizational factors and mortality. RESULTS: We included 5719 patients. Only 1710 (29.9%) were on target sedation levels on day 2. Board-certified intensivists on the morning and afternoon shifts were associated with an adequate sedation level on day 2 (OR = 2.43; CI 95%, 1.09-5.38). Target sedation levels were associated with reduced hospital mortality (OR = 0.63; CI 95%, 0.55-0.72). Mediation analysis also suggested such an association, but did not suggest a relationship between the physician staffing model and hospital mortality. CONCLUSIONS: Board-certified intensivists on morning and afternoon shifts were associated with an increased number of patients achieving lighter sedation goals. These findings reinforce the importance of organizational factors, such as intensivists' presence, as a modifiable quality improvement target.
40 schema:genre research_article
41 schema:inLanguage en
42 schema:isAccessibleForFree true
43 schema:isPartOf Na5854e95cda64a569f9be62b43054073
44 Nd60bc82464cd4bc39197c06ed7a050cc
45 sg:journal.1117766
46 schema:name Organizational factors associated with target sedation on the first 48 h of mechanical ventilation: an analysis of checklist-ICU database
47 schema:pagination 34
48 schema:productId N1fdb7490a9624eb9aa302716b6f39b2d
49 N2ba60193b0214cdabd4fa9604290245d
50 N4966fbd5705b447d82eb017ce3f68039
51 N724b8a8084d04b3f97945a6a98d21996
52 N7c30d7ffc2f44e159e49f5a241a44c76
53 schema:sameAs https://app.dimensions.ai/details/publication/pub.1111765566
54 https://doi.org/10.1186/s13054-019-2323-y
55 schema:sdDatePublished 2019-04-11T09:00
56 schema:sdLicense https://scigraph.springernature.com/explorer/license/
57 schema:sdPublisher Nd4b1a90e9c2a47dfa313b6dc7123f6a2
58 schema:url https://link.springer.com/10.1186%2Fs13054-019-2323-y
59 sgo:license sg:explorer/license/
60 sgo:sdDataset articles
61 rdf:type schema:ScholarlyArticle
62 N0a36c92bc8304599aa9e6707956be008 schema:affiliation https://www.grid.ac/institutes/grid.477370.0
63 schema:familyName Damiani
64 schema:givenName Lucas P.
65 rdf:type schema:Person
66 N0ee13ff3667047a2bf5f198f341588de rdf:first Nbedc44b251fa41bda31e75b0221ed7b8
67 rdf:rest Na38799aeb8ba40838b380b852dcb81c3
68 N1fdb7490a9624eb9aa302716b6f39b2d schema:name pubmed_id
69 schema:value 30696474
70 rdf:type schema:PropertyValue
71 N2ba60193b0214cdabd4fa9604290245d schema:name readcube_id
72 schema:value 9e94e7d3feed95c9598636676e8431b4991921492af4ea02b2700c6ca9609009
73 rdf:type schema:PropertyValue
74 N31d261005f7d487b93f051797daf1d1a rdf:first Nf6fd5826115946c385b0143b384a03cd
75 rdf:rest rdf:nil
76 N3450eaa7dda145d7b2946f3eea904c7b rdf:first Ndb3fe538d3f441849476d068e6c9cf6f
77 rdf:rest Nc4cebc1f190148bf8c21a4c150615d13
78 N3a91763af6fc471b93d20aa03bc11ed1 rdf:first N0a36c92bc8304599aa9e6707956be008
79 rdf:rest N31d261005f7d487b93f051797daf1d1a
80 N4966fbd5705b447d82eb017ce3f68039 schema:name nlm_unique_id
81 schema:value 9801902
82 rdf:type schema:PropertyValue
83 N4e5ca33c0795486e801f659ef83551ee schema:affiliation https://www.grid.ac/institutes/grid.418068.3
84 schema:familyName Bozza
85 schema:givenName Fernando A.
86 rdf:type schema:Person
87 N6cf2408d394b428ea38d58c604b63dda rdf:first Nbaae26c072da4b489c33bb48332682e0
88 rdf:rest N3a91763af6fc471b93d20aa03bc11ed1
89 N724b8a8084d04b3f97945a6a98d21996 schema:name doi
90 schema:value 10.1186/s13054-019-2323-y
91 rdf:type schema:PropertyValue
92 N7c30d7ffc2f44e159e49f5a241a44c76 schema:name dimensions_id
93 schema:value pub.1111765566
94 rdf:type schema:PropertyValue
95 N83474578f80a4f29a278607a94da8b94 rdf:first Ned2166f9c1584787a547a71e4a63a428
96 rdf:rest N6cf2408d394b428ea38d58c604b63dda
97 Na38799aeb8ba40838b380b852dcb81c3 rdf:first Nbfa2d370f34b43cca4ada3f0f1474928
98 rdf:rest N3450eaa7dda145d7b2946f3eea904c7b
99 Na5854e95cda64a569f9be62b43054073 schema:volumeNumber 23
100 rdf:type schema:PublicationVolume
101 Nbaae26c072da4b489c33bb48332682e0 schema:affiliation https://www.grid.ac/institutes/grid.411249.b
102 schema:familyName Guimarães
103 schema:givenName Helio Penna
104 rdf:type schema:Person
105 Nbedc44b251fa41bda31e75b0221ed7b8 schema:affiliation https://www.grid.ac/institutes/grid.413320.7
106 schema:familyName Nassar
107 schema:givenName Antonio Paulo
108 rdf:type schema:Person
109 Nbfa2d370f34b43cca4ada3f0f1474928 schema:affiliation https://www.grid.ac/institutes/grid.414358.f
110 schema:familyName Zampieri
111 schema:givenName Fernando G.
112 rdf:type schema:Person
113 Nc4cebc1f190148bf8c21a4c150615d13 rdf:first N4e5ca33c0795486e801f659ef83551ee
114 rdf:rest N83474578f80a4f29a278607a94da8b94
115 Nd4b1a90e9c2a47dfa313b6dc7123f6a2 schema:name Springer Nature - SN SciGraph project
116 rdf:type schema:Organization
117 Nd60bc82464cd4bc39197c06ed7a050cc schema:issueNumber 1
118 rdf:type schema:PublicationIssue
119 Ndb3fe538d3f441849476d068e6c9cf6f schema:affiliation https://www.grid.ac/institutes/grid.8536.8
120 schema:familyName Salluh
121 schema:givenName Jorge I.
122 rdf:type schema:Person
123 Ned2166f9c1584787a547a71e4a63a428 schema:affiliation https://www.grid.ac/institutes/grid.411249.b
124 schema:familyName Machado
125 schema:givenName Flávia Ribeiro
126 rdf:type schema:Person
127 Nf6fd5826115946c385b0143b384a03cd schema:affiliation https://www.grid.ac/institutes/grid.477370.0
128 schema:familyName Cavalcanti
129 schema:givenName Alexandre Biasi
130 rdf:type schema:Person
131 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
132 schema:name Medical and Health Sciences
133 rdf:type schema:DefinedTerm
134 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
135 schema:name Clinical Sciences
136 rdf:type schema:DefinedTerm
137 sg:journal.1117766 schema:issn 1364-8535
138 1466-609X
139 schema:name Critical Care
140 rdf:type schema:Periodical
141 sg:pub.10.1007/s00134-013-2830-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1021295774
142 https://doi.org/10.1007/s00134-013-2830-2
143 rdf:type schema:CreativeWork
144 sg:pub.10.1007/s00134-015-4076-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1014364517
145 https://doi.org/10.1007/s00134-015-4076-7
146 rdf:type schema:CreativeWork
147 sg:pub.10.1186/cc12594 schema:sameAs https://app.dimensions.ai/details/publication/pub.1010078566
148 https://doi.org/10.1186/cc12594
149 rdf:type schema:CreativeWork
150 sg:pub.10.1186/s13012-014-0190-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026539415
151 https://doi.org/10.1186/s13012-014-0190-0
152 rdf:type schema:CreativeWork
153 sg:pub.10.1186/s13054-015-0929-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1041903373
154 https://doi.org/10.1186/s13054-015-0929-2
155 rdf:type schema:CreativeWork
156 https://app.dimensions.ai/details/publication/pub.1077693076 schema:CreativeWork
157 https://doi.org/10.1001/archinternmed.2009.521 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032102987
158 rdf:type schema:CreativeWork
159 https://doi.org/10.1001/jama.2012.13872 schema:sameAs https://app.dimensions.ai/details/publication/pub.1042399008
160 rdf:type schema:CreativeWork
161 https://doi.org/10.1001/jama.2013.5154 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052797121
162 rdf:type schema:CreativeWork
163 https://doi.org/10.1001/jama.2014.18399 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035391523
164 rdf:type schema:CreativeWork
165 https://doi.org/10.1001/jama.2016.0154 schema:sameAs https://app.dimensions.ai/details/publication/pub.1003581306
166 rdf:type schema:CreativeWork
167 https://doi.org/10.1001/jama.2018.9183 schema:sameAs https://app.dimensions.ai/details/publication/pub.1105804017
168 rdf:type schema:CreativeWork
169 https://doi.org/10.1001/jamainternmed.2016.8457 schema:sameAs https://app.dimensions.ai/details/publication/pub.1074216745
170 rdf:type schema:CreativeWork
171 https://doi.org/10.1016/j.chest.2017.03.054 schema:sameAs https://app.dimensions.ai/details/publication/pub.1085038954
172 rdf:type schema:CreativeWork
173 https://doi.org/10.1016/j.chest.2017.05.041 schema:sameAs https://app.dimensions.ai/details/publication/pub.1086112046
174 rdf:type schema:CreativeWork
175 https://doi.org/10.1016/j.mayocp.2015.02.016 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026343381
176 rdf:type schema:CreativeWork
177 https://doi.org/10.1016/s2213-2600(17)30304-1 schema:sameAs https://app.dimensions.ai/details/publication/pub.1091845886
178 rdf:type schema:CreativeWork
179 https://doi.org/10.1056/nejm200005183422002 schema:sameAs https://app.dimensions.ai/details/publication/pub.1051418418
180 rdf:type schema:CreativeWork
181 https://doi.org/10.1080/01621459.1992.10475190 schema:sameAs https://app.dimensions.ai/details/publication/pub.1058304219
182 rdf:type schema:CreativeWork
183 https://doi.org/10.1097/01.ccm.0000300275.63811.b3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1021776492
184 rdf:type schema:CreativeWork
185 https://doi.org/10.1097/ccm.0000000000000754 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018947403
186 rdf:type schema:CreativeWork
187 https://doi.org/10.1097/ccm.0000000000001854 schema:sameAs https://app.dimensions.ai/details/publication/pub.1039287789
188 rdf:type schema:CreativeWork
189 https://doi.org/10.1097/ccm.0000000000002373 schema:sameAs https://app.dimensions.ai/details/publication/pub.1084764272
190 rdf:type schema:CreativeWork
191 https://doi.org/10.1097/ccm.0000000000002413 schema:sameAs https://app.dimensions.ai/details/publication/pub.1085065216
192 rdf:type schema:CreativeWork
193 https://doi.org/10.1097/ccm.0000000000002885 schema:sameAs https://app.dimensions.ai/details/publication/pub.1099645802
194 rdf:type schema:CreativeWork
195 https://doi.org/10.1097/ccm.0000000000003071 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101323702
196 rdf:type schema:CreativeWork
197 https://doi.org/10.1097/ccm.0b013e318168f82d schema:sameAs https://app.dimensions.ai/details/publication/pub.1002483372
198 rdf:type schema:CreativeWork
199 https://doi.org/10.1097/ccm.0b013e318292313a schema:sameAs https://app.dimensions.ai/details/publication/pub.1042844683
200 rdf:type schema:CreativeWork
201 https://doi.org/10.1164/rccm.201203-0522oc schema:sameAs https://app.dimensions.ai/details/publication/pub.1041214075
202 rdf:type schema:CreativeWork
203 https://doi.org/10.1177/0310057x0803600423 schema:sameAs https://app.dimensions.ai/details/publication/pub.1077693076
204 rdf:type schema:CreativeWork
205 https://doi.org/10.1177/1062860618766614 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101849284
206 rdf:type schema:CreativeWork
207 https://doi.org/10.1345/aph.1r037 schema:sameAs https://app.dimensions.ai/details/publication/pub.1053147537
208 rdf:type schema:CreativeWork
209 https://doi.org/10.1378/chest.114.2.541 schema:sameAs https://app.dimensions.ai/details/publication/pub.1051995437
210 rdf:type schema:CreativeWork
211 https://www.grid.ac/institutes/grid.411249.b schema:alternateName Federal University of Sao Paulo
212 schema:name Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, Brazil
213 Federal univeristy of São Paulo, São Paulo, Brazil
214 Research Institute, HCor-Hospital do Coração, São Paulo, Brazil
215 rdf:type schema:Organization
216 https://www.grid.ac/institutes/grid.413320.7 schema:alternateName AC Camargo Hospital
217 schema:name Intensive Care Unit and Postgraduate Program, A.C. Camargo Cancer Center, São Paulo, Brazil
218 rdf:type schema:Organization
219 https://www.grid.ac/institutes/grid.414358.f schema:alternateName Hospital Alemão Oswaldo Cruz
220 schema:name Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
221 Research Institute, HCor-Hospital do Coração, São Paulo, Brazil
222 rdf:type schema:Organization
223 https://www.grid.ac/institutes/grid.418068.3 schema:alternateName Oswaldo Cruz Foundation
224 schema:name Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Instituto D’Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
225 rdf:type schema:Organization
226 https://www.grid.ac/institutes/grid.477370.0 schema:alternateName Hospital do Coração
227 schema:name Research Institute, HCor-Hospital do Coração, São Paulo, Brazil
228 rdf:type schema:Organization
229 https://www.grid.ac/institutes/grid.8536.8 schema:alternateName Federal University of Rio de Janeiro
230 schema:name Graduate Program in Translational Medicine and Department of Critical Care, D’Or Institute for Research and Education, Rio De Janeiro, Brazil
231 Programa de Pós-Graduação em Clinica médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
232 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...