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VOLUME 1 , ISSUE 3-4 ( July-December, 2023 ) > List of Articles

SURVEY

Sedation Practices during VV-ECMO in Indian Scenario: A Retrospective Survey

Vikrant Shamrao Pawar

Keywords : Sedation, Survey, Venovenous extracorporeal membrane oxygenation

Citation Information : Pawar VS. Sedation Practices during VV-ECMO in Indian Scenario: A Retrospective Survey. Indian J ECMO 2023; 1 (3-4):99-103.

DOI: 10.5005/jaypee-journals-11011-0022

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim and background: There has been an exponential rise in the use of venovenous extracorporeal membrane (VV-ECMO) in patients who develop acute respiratory distress syndrome (ARDS), as observed in Indian hospitals. In spite of the ever-increasing cases of patients being treated with VV-ECMO, there is scarcity of literature about sedation management in this patient group. This retrospective, online questionnaire-based survey was undertaken with an aim of gaining an overview of what majority institutes in India are practicing with respect to sedation during VV-ECMO, so that it can contribute to the smallest extent in forming policies and protocols. Materials and methods: This survey was formulated on SurveyMonkey application and shared with members of ECMO society of India (ESOI) through WhatsApp. Their responses were recorded and analyzed through SurveyMonkey application. Results: Fentanyl was found to be the most widely used drug followed by midazolam and fentanyl plus midazolam was the most commonly used combination. Majority of participants (83.33%) use Richmond Agitation-Sedation Scale (RASS) for monitoring agitation. Only other scale being used is the Ramsay scale. Incidence of delirium was less than 10% in most intensive care units (ICUs). Majority of participants (54.17%) required deep sedation for less than 5 days to keep their patients calm and comfortable. Physiotherapy was given during both deep and light sedation in most of the units (60%). Conclusion: We found substantial uniformity with respect to choice of agitation scales used, initiation of physiotherapy, incidence of delirium and number of days on deep sedation among the centers across India. Clinical significance: Although this survey gives a glimpse of sedation practices in VV-ECMO in many centers across India, more surveys and studies are required on this topic.

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