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sedation holiday

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7.3 - Sedation and Neuromuscular Blockade in Intensive Care
from Section 7 - Comfort and Recovery
- By Edward Rintoul, Jeff Philips
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 660-662
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Summary

Key Learning Points
1. Goldilocks principle – always aim for just the right amount of sedation, comfort without coma.
2. Use of sedation holds/‘holidays’ can reduce the length of ventilator days.
3. Sedation protocols vary between institutions, but all rely on regular assessment of depth of sedation with standardised scoring systems.
4. Use of neuromuscular blockade in critical care has modest association with neuromuscular dysfunction seen in critical illness weakness.
5. Use of early neuromuscular blockade in moderate to severe acute respiratory distress syndrome has been shown to reduce mortality.