Researchers who studied patients with respiratory failure found that while many patients on ventilators were under deep sedation, Hispanic patients were much more likely to be under deep sedation. found that it was high.

From left: Mari Armstrong Huff of New York University’s School of Global Public Health and Thomas Valley, M.D. of the University of Michigan.

In fact, Hispanic patients on ventilators were five times more likely to be placed under deep sedation than white patients. American Thoracic Society Annual Report. Researchers say this is important because patients under deep sedation may be at increased risk of complications, including death.

According to the National Institutes of Health, researchers tested patients with acute respiratory distress syndrome (ARDS), a serious lung disease that causes low blood oxygen. According to the Mayo Clinic, it is often caused by other conditions such as sepsis, pneumonia, or COVID-19. Many patients with ARDS must be placed on a ventilator to help them breathe.

Study co-author Thomas Valley, M.D., Ph.D., associate professor of respiratory and critical care medicine at the University of Michigan, said in an interview that researchers conducted the study to try to understand why Hispanic patients with respiratory failure are more likely to develop respiratory failure. He said he started. There is a high possibility that you will die.

“We wondered if sedation, deep sedation, might serve as one of the mechanisms that could explain that difference,” Valley says.

Although it’s unclear whether deep sedation is responsible for increased mortality in Hispanic patients, Valley said it’s likely that Hispanic patients on ventilators are much more likely to be placed under deep sedation. This is clear from the research results.

“This is absolutely a big deal,” Valley said.

But most patients on ventilators, regardless of race or ethnicity, spend at least some time in deep sedation, another important finding, the researchers said. .

Researchers analyzed 505 patients with moderate to severe ARDS at 48 hospitals across the country. The patient was on a ventilator and light sedation was recommended, researchers said.

“Hispanic patients were more likely to be deeply sedated than non-Hispanic patients. But the other important thing is, we’re still deep sedating everyone,” Valley said. he said. “We’re just sedating Hispanic patients more deeply. So there’s a lot of room for improvement for everyone, but especially for Hispanic patients.”

Researchers found that more than 90% of patients tested were deeply sedated at some point during the first five days after being placed on a ventilator, and patients spent nearly 75% of those days in deep sedation. He is said to have spent his time in the state.

Mari Armstrong-Huff, co-principal investigator of the study and assistant professor of social and behavioral sciences and epidemiology at New York University’s School of Global Public Health, said in an interview that most people were deeply sedated on the first day. Told.

“Almost everyone is given deep sedation for at least a day,” Armstrong-Huff said. However, this difference occurs when some patients are deeply sedated for long periods of time. “Some patients are deeply sedated for long periods of time, while others are not,” she said.

Importantly, Armstrong-Huff said, hospitals with at least one Hispanic patient were administering sedatives more frequently to all patients.

At the hospital where the Hispanic patients were admitted, all patients were on ventilators and under deep sedation for 86% of the day. However, in a hospital with no Hispanic patients, all patients were deeply sedated for 66% of their ventilator days. Even after adjusting for “significant hospital-level effects,” researchers found that Hispanic patients were five times more likely to be deeply sedated, Armstrong-Huff said.

Patients under deep sedation can have serious long-term problems, Valley said. For years, healthcare providers viewed deep sedation as a way to keep patients comfortable on ventilators, Valley said, and the impact on patients was considered neutral. Over the past few decades, doctors and researchers have come to understand that deep sedation can lead to more serious complications.

“If you knock a patient out, they’re more likely to develop delirium,” Valley says. “They’re more likely to have memory problems. They’re more likely to be debilitated after they leave the ICU, and they’re more likely to die. So we use ventilators to deeply Sedation can have serious consequences.”

The analysis did not specify why Hispanic patients were more likely to be placed under deep sedation, but language barriers could be a factor, Armstrong-Huff said.

“Language discrepancies can lead to differences in the assessment of agitation or delirium, or the recognition of agitation or delirium,” she says. “So that may explain some of the differences we’re seeing, but answering that question will require further research and probably more detailed data than we have access to.” You will need it.”

Valley said he looks forward to additional analysis to examine why Hispanic patients are more likely to be placed under heavy sedation.

“The important next step for us is to try to understand what is happening at the bedside that is causing this problem,” says Valley.