Sedation and restraint use can reflect the same underlying agitation.
A secondary analysis of 711 ventilated adults in 51 Canadian ICUs found restraints were used in about half. Higher benzodiazepine doses and several other treatment features were associated with restraint use or longer restraint duration.
The analysis was observational. Agitation, device removal and treatment choices can influence one another; dose equivalence and model adjustment do not resolve every causal direction.
Reconstruct the sequence of agitation, dosing, restraint orders and bedside reassessments. The association cannot establish that benzodiazepines caused restraint use, that restraints justified additional medication, or that either intervention was appropriate in an individual episode.
Source: PMC4075126, supplied full-text paper. Findings are paraphrased; case-review implications are an interpretation.
Related: Forensic Toxicology: expert analysis and case review.