MỘT SỐ YẾU TỐ ẢNH HƯỞNG ĐẾN THANG ĐIỂM RASS TRONG THEO DÕI VÀ CHĂM SÓC NGƯỜI BỆNH THỞ MÁY XÂM NHẬP CÓ SỬ DỤNG THUỐC AN THẦN

Abstract

Objective: To evaluate factors effect the RASS scoring in mechanically ventilated patients using sedatives in the Center for Critical Care Medicine at Bach Mai Hospital. Method: a prospective interventional study was carried out on 60 mechanically ventilated patients using sedation with 1281 scoring of RASS at the Center for Critical Care Medicine of Bach Mai Hospital from August 2023 to April 2024. Results: Male/female ratio was 2:1, the mean age was 59.87± 19.40, the common age group was 60 - 80 years old. The most common indication for  sedation is excitement related to respiratory diseases with 66.7%. The mean RASS at the beginning  was -2.58 ± 2.39 and in third and fourth day was -1.29 ± 2.71 and -1.5 ± 2.2, respectively (p < 0.05). RASS scores were not different between gender groups, age groups, BMI groups and type of sedation used (p>0.05). In patients on mechanical ventilation for more than 72 hours, the mean RASS was lower with p < 0.05. There was a similarity in the RASS scores at T0 scored by  the researchers and nurses (kappa: 0.763 with p=0.066), and by the researchers and doctors (kappa: 0.554, p=0.074). Conclusions: The RASS score can be applied to various different patient groups regardless of gender, age, physical condition, or different sedation protocols. There is a high degree of appropriateness when implementing RASS score between doctor and nurses.