SPICE: Sedation Practices in Intensive Care Observational Study
The SPICE Observational Study was a prospective, observational inception cohort study. The study was conducted in ICUs in Australia and New Zealand and recruited 300 patients.
Goal: The main objective of this study was to generate information regarding baseline practice with respect to the management of sedation, analgesia, agitation, and delirium in order to guide the design of subsequent randomised controlled trials. The study measured the administration of sedative and analgesic drugs; assessed the cognitive state associated with the administration of sedative and analgesic drugs in critical illness; assessed whether a pre-specified level of sedation is targeted and whether that level of sedation is achieved; identified patient, site, and treatment related factors that are associated with increased risk of over-sedation defined by RASS and CAM-ICU; and identified patterns of use of sedation including drug/s choice (including drug cessation), dosages and combination therapy.
Rationale: It was not known if different strategies and / or the use of different drugs to achieve sedation and analgesia result in differences in patient outcomes, although several lines of evidence suggest that this is plausible. Several studies report differences in duration of mechanical ventilation or duration of admission in association with different strategies for the administration of sedation. There was evidence that sedation strategy or choice of sedative agent can influence long-term outcomes, including survival and psychological outcomes. Furthermore, observational studies reported an association with strong effect size between the occurrence and duration of delirium in critically ill patients, and subsequent long-term survival.
Study Progress: Patient recruitment has been completed.
Endorsement: The SPICE Study was endorsed by the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS-CTG).
Contact: For further information about this study, please contact Belinda Howe, on email: belinda.howe@monash.edu.
SPICE Observational Study
