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Motor Activity Assessment Scale: A valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit

Devlin, John W., Boleski, Gail, Mlynarek, Mark, Nerenz, David R., Peterson, Edward, Jankowski, Michelle, Horst, H. Mathilda, Zarowitz, Barbara J.·1999·Critical Care Medicine

DOI 10.1097/00003246-199907000-00008

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Abstract

OBJECTIVE: To establish the validity and reliability of a new sedation scale, the Motor Activity Assessment Scale (MAAS). DESIGN: Prospective, psychometric evaluation. SETTING: Sixteen-bed surgical intensive care unit (SICU) of a 937-bed tertiary care, university-affiliated teaching hospital. PATIENTS: Twenty-five randomly selected, adult, mechanically ventilated, nonneurosurgical patients who were admitted to the SICU > or = 12 hrs after surgery and were not receiving neuromuscular blockers. INTERVENTION: Four hundred assessments (eight per patient) were completed consecutively but independently, in pairs, at standardized times (both day and night) by two nurses who were preselected for each assessment from a pool of 32 pretrained SICU nurses. MEASUREMENTS AND MAIN RESULTS: To estimate validity, paired assessments (four/patient) compared the MAAS result with the subjective assessment using a 10-cm visual analog sedation scale, the percent change in blood pressure and heart rate from the previous 4-hr baselines, and the number of recent agitation-related sequelae. To estimate reliability, paired assessments (four/patient) measured correlation between assessments of the same type (e.g., MAAS-MAAS). Generalized estimating equations, which accounted for the four repeated measures in each patient, supported MAAS validity by finding a linear trend between MAAS and the visual analog scale (p < .001), blood pressure (p < .001), heart rate (p < .001), and agitation-related sequelae (p < .001) end points. The MAAS (kappa = 0.83 [95% confidence interval, 0.72 to 0.94]) was found to be more reliable than subjective assessment using the visual analog scale (intraclass correlation coefficient = 0.32 [95% confidence interval, 0.05 to 0.55]). CONCLUSIONS: The MAAS is a valid and reliable sedation scale for use with mechanically ventilated patients in the SICU. Further studies are warranted regarding the effect of MAAS implementation in our SICU on patient outcomes, such as quality of sedation and length of mechanical ventilation, as well as the use of the MAAS in other patient populations (e.g., medical).

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Authors: Devlin, J. W., Boleski, G., Mlynarek, M., Nerenz, D. R., Peterson, E., Jankowski, M., Horst, H. M., & Zarowitz, B. J.
Affiliations: Henry Ford Health (US)
ORCID: Devlin, John W.
Peterson, Edward
Zarowitz, Barbara J.
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1999-07
Volume: 27
Issue: 7
Pages: 1271-1275
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/00003246-199907000-00008
OpenAlex: W2012479097
Cited by: 328
References: 12
Citations by year: 2026: 4 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 10 · 2014: 7 · 2013: 20 · 2012: 25
FWCI: 12.13
Type: journal article
Language: en
Open access: closed
Locations: Critical Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Health Sciences › Medicine › Surgery › Nausea and vomiting management
Keywords: sedation assessment, mechanical ventilation, surgical intensive care unit, postoperative sedation, agitation, visual analogue scale
MeSH terms: Adult, Female, Humans, Hypnotics and Sedatives, Intensive Care Units, Male, Middle Aged, Postoperative Care, Psychometrics, Psychomotor Agitation, Respiration, Artificial, Reproducibility of Results, Linear Models, Drug Monitoring

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Motor Activity Assessment Scale: A valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit

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