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Chapter 22 - Sedation in the Intensive Care Setting

Published online by Cambridge University Press:  12 December 2024

By
Iaswarya Ganapathiraju  and
John P. Gaillard
Edited by
Richard D. Urman  and
Alan David Kaye
Richard D. Urman
Affiliation:
Ohio State University
Alan David Kaye
Affiliation:
Louisiana State University School of Medicine
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Summary

Critically ill patients in the intensive care unit (ICU) often require sedation and analgesia as part of a comprehensive care plan. Inappropriate sedation and analgesia (too little or too much) are known to lead to adverse outcomes in this patient population, including increasing the risk of delirium, worsening hemodynamics, or interrupting life-sustaining therapies, etc. [1]. In recent years, there has been a paradigm shift in providing sedation and analgesia to minimize physical discomfort and psycho-emotional stress while maintaining the patient’s ability to interact with care providers. Balancing patient comfort and cognition with the need to provide appropriate care requires the critical care provider to have a comprehensive understanding of the pharmacodynamics of sedatives and analgesics, and to also to remain vigilant in evaluating ongoing needs for sedation and analgesia.

Type
Chapter
Information
Moderate and Deep Sedation in Clinical Practice , pp. 274 - 284
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

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Additional Reading

Aitken, LM et al. Protocol-directed sedation versus non-protocol-directed sedation to reduce duration of mechanical ventilation in mechanically ventilated intensive care patients. Cochrane Database Syst. Rev. 2015;1:CD009771.Google ScholarPubMed
Aitken, LM et al. Sedation protocols to reduce duration of mechanical ventilation in the ICU: a Cochrane Systematic Review. J. Adv. Nurs. 2016;72:261–72.CrossRefGoogle ScholarPubMed
Ely, EW et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286:2703–10.CrossRefGoogle ScholarPubMed
Slooter, AJ et al. Delirium in critically ill patients. Handb Clin Neurol. 2017;141:449–66.CrossRefGoogle ScholarPubMed

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