Abrahamian , Andrew

Assaly , Ragheb

Barnett , William

Guo, Anna

Holtzapple, Zachary

Irvin, Jonathan

Kaminski , Brian

Khan, Saira

Ko, Rachel

Wright, Dan

English

University of Toledo Open Journal System

The University of Toledo Translation Journal of Medical Sciences Pulmonology Abstract, Dr. Lance D. Dworkin Department of Medicine Research Symposium UTJMS 2023 December 14; 11(3):e1-e2 https://dx.doi.org/10.46570/utjms.vol11-2023-936  1  ©2023 UTJMS Title- Effects of Fentanyl Exposure during Mechanical Ventilation: A Retrospective Study Rachel Ko1, Dan Wright1, Jonathan Irvin1, Anna Guo1, Saira Khan1, Zachary Holtzapple, MD2, Andrew Abrahamian, MD2, William Barnett, MS2, Brian Kaminski, DO3, Ragheb Assaly, MD4 1College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43614 2Division of Internal Medicine, Department of Medicine, The University of Toledo, Toledo, OH 43614 3Department of Emergency Medicine, ProMedica, Toledo, OH 43615 4Division of Pulmonary and Critical Care, Department of Medicine, The University of Toledo, Toledo, OH 43614 *Corresponding author:  rachel.ko@rockets.utoledo.eduKeywords: Internal Medicine, Critical Medicine, Quality Improvement Published: 14 December 2023 Background: Analgesics and sedation are often administered to ensure the comfort and safety of patients receiving mechanical ventilation (1). Patients are commonly treated with fentanyl, an opioid, to provide both pain control and sedation while mechanically ventilated. As opposed to benzodiazepines or propofol, fentanyl results in better pain control but is associated with risks such as chest wall rigidity, that may negatively impact outcomes of patients placed on mechanical ventilation (1, 2). Objective: To assess the impact of fentanyl exposure on the outcomes of patients who undergo mechanical ventilation. Methods: This study was a retrospective cohort study of 1191 patients from a tertiary care center. Data was gathered for all mechanically ventilated patients that survived to discharge from 2019-2022. The cumulative dose of fentanyl was quantified throughout the patient’s hospital stay. Outcomes including ICU and total length of stay were ascertained upon review of the patient’s medical record. Results: Greater fentanyl exposure was associated with a longer duration of ICU and total hospital length of stay. ICU length of stay increased by 1.09 days when exposed to low doses of fentanyl and 8.78 days with higher exposure. High-dose fentanyl exposure increased total hospital length of stay by 9.71 days.  Conclusions: Higher levels of fentanyl exposure while on ventilator support significantly increased ICU and total hospital length of stay. Longer length of stay is associated with negative health outcomes such as hospital-acquired infection and cardiac arrythmias. High doses of fentanyl in critically ill patients predisposes them to serious and life-threatening medical complications. https://dx.doi.org/10.46570/utjms.vol11-2023-936 UTJMS 11(3):e1-e2    https://dx.doi.org/10.46570/utjms.vol11-2023-936 2 ©2023 UTJMS      References 1. Tedders, K.M., McNorton K.N., and Edwin S.B. Efficacy and safety of analgosedation with fentanyl compared with traditional sedation with propofol. Pharmacotherapy, 2014. 34(6): p. 643-7. 2. McGreevy, J.L., Piraino, S.T., and Sandhu, G. Fentanyl-Associated Serotonin Syndrome and Chest Wall Rigidity in an Intensive Care Unit Patient. Am J Ther, 2019. 26(5): p. e612-e614.  

Effects of Fentanyl Exposure during Mechanical Ventilation: A Retrospective Study

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Effects of Fentanyl Exposure during Mechanical Ventilation: A Retrospective Study

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