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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

21.12.2023 | Reports of Original Investigations

Physicians’ beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists

verfasst von: Mar Saavedra-Mitjans, PharmD, Anne Julie Frenette, PharmD, PhD, Victoria A. McCredie, MBChB, PhD, Lisa Burry, PharmD, PhD, Caroline Arbour, RN, PhD, Sangeeta Mehta, MD, Emmanuel Charbonney, MD, PhD, Han Ting Wang, MD, MSc, Martin Albert, MD, Francis Bernard, MD, David Williamson, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 2/2024

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Abstract

Purpose

Agitation is a common behavioural problem following traumatic brain injury (TBI). Intensive care unit (ICU) physicians’ perspectives regarding TBI-associated agitation are unknown. Our objective was to describe physicians’ beliefs and perceived importance of TBI-associated agitation in critically ill patients.

Methods

Following current standard guidance, we built an electronic, self-administrated, 42-item survey, pretested it for reliability and validity, and distributed it to 219 physicians working in 18 ICU level-1 trauma centres in Canada. We report the results using descriptive statistics.

Results

The overall response rate was 93/219 (42%), and 76/93 (82%) respondents completed the full survey. Most respondents were men with ten or more years of experience. Respondents believed that pre-existing dementia (90%) and regular recreational drug use (86%) are risk factors for agitation. Concerning management, 91% believed that the use of physical restraints could worsen agitation, 90% believed that having family at the bedside reduces agitation, and 72% believed that alpha-2 adrenergic agonists are efficacious for managing TBI agitation. Variability was observed in beliefs on epidemiology, sex, gender, age, socioeconomic status, and other pharmacologic options. Respondents considered TBI agitation frequent enough to justify the implementation of management protocols (87%), perceived the current level of clinical evidence on TBI agitation management to be insufficient (84%), and expressed concerns about acute and long-term detrimental outcomes and burden to patients, health care professionals, and relatives (85%).

Conclusion

Traumatic brain injury-associated agitation in critically ill patients was perceived as an important issue for most ICU physicians. Physicians agreed on multiple approaches to manage TBI-associated agitation although agreement on epidemiology and risk factors was variable.

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Titel: Physicians’ beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists
verfasst von: Mar Saavedra-Mitjans, PharmD
Anne Julie Frenette, PharmD, PhD
Victoria A. McCredie, MBChB, PhD
Lisa Burry, PharmD, PhD
Caroline Arbour, RN, PhD
Sangeeta Mehta, MD
Emmanuel Charbonney, MD, PhD
Han Ting Wang, MD, MSc
Martin Albert, MD
Francis Bernard, MD
David Williamson, PhD
Publikationsdatum: 21.12.2023
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 2/2024
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02666-1

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Physicians’ beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists