Sedation in intensive care units
Critically ill patients during the treatment in the intensive care units (ICU) are exposed to various interventions and stressors from the environment that represent a significant source of discomfort. Sedative and analgesic medications are commonly administered to provide comfort and improve tolera...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Serbian Society of Anesthesiologists and Intensivists
2018-01-01
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| Series: | Serbian Journal of Anesthesia and Intensive Therapy |
| Subjects: | |
| Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/2217-7744/2018/2217-77441802061V.pdf |
| _version_ | 1811221293120356352 |
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| author | Veličković Jelena Palibrk Ivan |
| author_facet | Veličković Jelena Palibrk Ivan |
| author_sort | Veličković Jelena |
| collection | DOAJ |
| description | Critically ill patients during the treatment in the intensive care units (ICU) are exposed to various interventions and stressors from the environment that represent a significant source of discomfort. Sedative and analgesic medications are commonly administered to provide comfort and improve tolerance of ICU management. It has been recognized that pain and delirium, coupled with oversedation, are associated with increased morbidity and mortality if not properly addressed. Routine monitoring with reliable tools enables early detection of agitation and pain, thus avoiding excessive sedation and harsh consequences of delirium. Individual approach implies selection of medications that meet patient's needs while taking into account the presence of organ dysfunctions that may influence drug metabolism and predispose a patient to severe side effects of sedation. The current evidence reveals that a deep sedation should always be avoided as long as there is no mandatory clinical indication. The newest guidelines also suggest the use of non-benzodiazepine (either propofol or dexmedetomidine) sedation whenever feasible to improve clinical outcomes in mechanically ventilated patients. Aside from specific situations (increased intracranial pressure, the administration of muscle relaxants, seizures) the required goal should be an alert, cooperative patient who can tolerate necessary interventions in the ICU. It has been demonstrated that daily interruption of sedation and sleep promotion are beneficial in decreasing the duration of mechanical ventilation and decreasing the incidence of cognitive impairments. Further studies are needed to elucidate the association of non-pharmacological interventions with long-term psychological outcomes. |
| first_indexed | 2024-04-12T07:56:52Z |
| format | Article |
| id | doaj.art-c49dd0d97f3f4edebf7d352e24ac1f2b |
| institution | Directory Open Access Journal |
| issn | 2217-7744 2466-488X |
| language | English |
| last_indexed | 2024-04-12T07:56:52Z |
| publishDate | 2018-01-01 |
| publisher | Serbian Society of Anesthesiologists and Intensivists |
| record_format | Article |
| series | Serbian Journal of Anesthesia and Intensive Therapy |
| spelling | doaj.art-c49dd0d97f3f4edebf7d352e24ac1f2b2022-12-22T03:41:28ZengSerbian Society of Anesthesiologists and IntensivistsSerbian Journal of Anesthesia and Intensive Therapy2217-77442466-488X2018-01-01401-261682217-77441802061VSedation in intensive care unitsVeličković Jelena0Palibrk Ivan1Klinički centar Srbije, Centar za anesteziologiju i reanimatologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet, BeogradKlinički centar Srbije, Centar za anesteziologiju i reanimatologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet, BeogradCritically ill patients during the treatment in the intensive care units (ICU) are exposed to various interventions and stressors from the environment that represent a significant source of discomfort. Sedative and analgesic medications are commonly administered to provide comfort and improve tolerance of ICU management. It has been recognized that pain and delirium, coupled with oversedation, are associated with increased morbidity and mortality if not properly addressed. Routine monitoring with reliable tools enables early detection of agitation and pain, thus avoiding excessive sedation and harsh consequences of delirium. Individual approach implies selection of medications that meet patient's needs while taking into account the presence of organ dysfunctions that may influence drug metabolism and predispose a patient to severe side effects of sedation. The current evidence reveals that a deep sedation should always be avoided as long as there is no mandatory clinical indication. The newest guidelines also suggest the use of non-benzodiazepine (either propofol or dexmedetomidine) sedation whenever feasible to improve clinical outcomes in mechanically ventilated patients. Aside from specific situations (increased intracranial pressure, the administration of muscle relaxants, seizures) the required goal should be an alert, cooperative patient who can tolerate necessary interventions in the ICU. It has been demonstrated that daily interruption of sedation and sleep promotion are beneficial in decreasing the duration of mechanical ventilation and decreasing the incidence of cognitive impairments. Further studies are needed to elucidate the association of non-pharmacological interventions with long-term psychological outcomes.https://scindeks-clanci.ceon.rs/data/pdf/2217-7744/2018/2217-77441802061V.pdfKeywords: sedationintensive care unitdeliriumanalgesia |
| spellingShingle | Veličković Jelena Palibrk Ivan Sedation in intensive care units Serbian Journal of Anesthesia and Intensive Therapy Keywords: sedation intensive care unit delirium analgesia |
| title | Sedation in intensive care units |
| title_full | Sedation in intensive care units |
| title_fullStr | Sedation in intensive care units |
| title_full_unstemmed | Sedation in intensive care units |
| title_short | Sedation in intensive care units |
| title_sort | sedation in intensive care units |
| topic | Keywords: sedation intensive care unit delirium analgesia |
| url | https://scindeks-clanci.ceon.rs/data/pdf/2217-7744/2018/2217-77441802061V.pdf |
| work_keys_str_mv | AT velickovicjelena sedationinintensivecareunits AT palibrkivan sedationinintensivecareunits |