Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34183
Title: Agitation during anaesthetic emergence: An observational study of adult cardiac surgery patients in two Australian intensive care units.
Austin Authors: Heily, Meredith;Gerdtz, Marie;Jarden, Rebecca J. ;Yap, Celene Yl;Darvall, Jai;Coventry, Andrew Ej;Rogers, Amy;Vernon, Julie;Bellomo, Rinaldo 
Affiliation: Intensive Care Unit, The Royal Melbourne Hospital, Grattan St, Parkville 3050, Australia; Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Level 6, Alan Gilbert Building, 161 Barry St, Carlton, 3010, Australia.
Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Level 6, Alan Gilbert Building, 161 Barry St, Carlton, 3010, Australia; Austin Health, Melbourne, Australia.
Intensive Care Unit & Department of Anaesthetics, The Royal Melbourne Hospital, Grattan St, Parkville, 3050, Australia; Department of Critical Care, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Grattan St, Parkville, 3010, Australia.
Intensive Care Unit, The Royal Melbourne Hospital, Grattan St, Parkville 3050, Australia.
Intensive Care Unit, The Royal Melbourne Hospital, Grattan St, Parkville 3050, Australia; Department of Critical Care, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Grattan St, Parkville, 3010, Australia.
Intensive Care
Issue Date: Jan-2024
Date: 2023
Publication information: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses 2024-01; 37(1)
Abstract: Anaesthetic emergence agitation among adult patients being recovered after open cardiac and/or thoracic aorta surgery has not been described. The objective of this study was to characterise emergence agitation in terms of incidence, clinical features, and consequences in a cohort of cardiac surgery patients being recovered in the intensive care unit (ICU). A prospective, observational pilot study was implemented. Over a 5-week period, the study was conducted in two metropolitan hospitals in Victoria, Australia. The cohort comprised all patients admitted to the ICUs aged ≥18 years, who had undergone cardiac surgery via an open sternotomy with general anaesthetic, and whose emergence was directly observed. Emergence agitation was defined as a Richmond Agitation and Sedation Scale score of ≥+2. Fifty patients were observed. Emergence agitation occurred in 24/50 (48%) of patients. Patients with emergence agitation experienced more clinical consequences than patients with calm emergence, including a significantly greater number of episodes of airway compromise (12/24, 50%, p < 0.001); ventilator dyssynchrony (23/24, 96%, p = 0.004); and hypertension (13/24, 54%, p = 0.004). Significant treatment interference (potentially dangerous patient movements such as pulling tubes) occurred with 23/24 patients (96%, p < 0.0001). Patients who underwent emergence agitation required significantly more interventions during anaesthetic emergence than patients who underwent a calm emergence. Interventions included extra nursing measures (16/24, 67%, p = 0.001) administration of sedative and/or opioid intravenous boluses (22/24, 92%, p = 0.001) and vasoactive agents (15/24, 63%, p = 0.05). In patients recovering from cardiac surgery in the ICU, emergence agitation was clinically important. Immediate interventions were required to prevent and manage complications.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34183
DOI: 10.1016/j.aucc.2023.09.003
ORCID: 
Journal: Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
PubMed URL: 37919133
Type: Journal Article
Subjects: Adults
Agitation
Anaesthetic emergence
Cardiac surgery
Intensive care unit
Observational study
Patients
Appears in Collections:Journal articles

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