Abstract:
:Critically ill intensive care unit (ICU) patients often require sedation to tolerate life-saving interventions such as mechanical ventilation. Pain, anxiety, and delirium all contribute to patient distress and agitation which can interfere with ICU medical care if not addressed and treated appropriately. Sedation practices to treat pain, anxiety, and delirium that deviate from established practice guidelines affect mechanical ventilation duration, ICU and hospital length of stay, functional impairment, and mortality. Historically patients were kept deeply sedated in the ICU. However, considerable research has demonstrated that minimizing sedation with the goal to achieve comfortable wakefulness is preferred in most ICU patients and is associated with improved clinical outcomes. This review will focus on changes in sedation practice in the ICU over the past three decades. With the implementation of validated sedation assessment scales, a multidisciplinary treatment model, and development of daily awakening protocols, no or minimal sedation can be achieved in the majority of ICU patients. Frequent, careful consideration of the environmental stimuli that contribute to patient discomfort and agitation and judicious use of sedative medications individualized to each patient are important in achieving this goal.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
DeBiasi EM,Akgün KM,Pisani Mdoi
10.1055/s-0035-1564875subject
Has Abstractpub_date
2015-12-01 00:00:00pages
899-913issue
6eissn
1069-3424issn
1098-9048journal_volume
36pub_type
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journal_title:Seminars in respiratory and critical care medicine
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