Recipient organisationNIHR Southampton Biomedical Research Centre
NIHR supportRecorded as supported by this research centre
PeriodJan 2025 — Dec 2026
In plain English
AI plain-English summary
Opioids are routinely given to patients on breathing machines in intensive care, but no one has systematically tracked how much is used, why, and what happens as a result. This matters because opioids can cause delirium, severe constipation, and may lead to long-term dependence after discharge. Doctors lack clear evidence on the safest doses and durations for ventilated ICU patients, so prescribing decisions are often based on habit rather than data. The research team will analyse the medical records of all adults who received mechanical ventilation for more than 24 hours at University Hospital Southampton. They will map the relationships between opioid dose and pain levels, agitation, delirium, constipation, length of ICU and hospital stay, time to successful removal of the breathing tube, and whether patients end up on long-term opioids or develop post-traumatic stress after leaving hospital. If this work succeeds, it will give ICU clinicians concrete, evidence-based guidance on opioid prescribing. That could reduce preventable harm—fewer cases of delirium, less constipation, shorter stays, and lower rates of opioid dependence after critical illness—without compromising pain relief.
View original technical description
Pain is common in intensive care units (ICUs), and it is important to treat pain adequately to improve patients’ outcome. Opioids is a class of strong painkillers, commonly used in intensive care units (ICUs) to treat pain, agitation, and facilitate mechanical ventilation (also known as “breathing machine”). However, there are important concerns about the safety of opioids use, this includes delirium (frequently manifests as confused thinking, lack of awareness of the surrounding and inattentiveness) and gastrointestinal side effects (such as constipation, nausea and vomiting). We propose to conduct a retrospective, observational study at University Hospital Southampton NHS Foundation Trust, seeking to learn the following: Prevalence of opioids use – How many patients with mechanical ventilation in ICU were prescribed with opioids? Indications - Why were patients prescribed opioids in ICU? Relationship between opioid dose and pain, agitation, and respiratory distress Relationship between age, gender, past medical history (including cognitive impairment), admission for a brain injury or trauma, previous medications, and opioid dose/exposure. Relationship between opioid dose/exposure and constipation Relationship between opioid dose/exposure and delirium Relationship between opioid dose/exposure and duration of ICU stay, duration of hospital stay, hospital mortality and time to the first successful extubation (“removal of assisted breathing or airways securing tube”). Relationship between opioid dose and use in ICU and long-term opioid prescription. Relationship between opioid dose and use in ICU and long-term opioid prescription, post-traumatic stress disorders and common post-ICU complications (e.g. nightmares, insomnia). All adult (aged >18 years old) patients that received mechanical ventilation for more than 24 hours at University Hospital Southampton (UHS) NHS Foundation trust are eligible to be included in this study. Patients who are younger than 18 years old, did not receive invasive mechanical ventilation or are moved to comfort or anticipatory care will be excluded.
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