Ieva Norkienė, Tomas Jovaiša, Mindaugas Šerpytis

Abstract

Ensuring patients safety and comfort is an important part of treatment applied in intensive care. Critical illness is associated with pain, agitation and often predispose development of intensive care unit delirium. Moreover, critical conditions and life threatening diseases often require aggressive organ system support and long term immobilization. Deep sedation is preferred by the clinicians in order to reduce discomfort experienced by the patient and prevent development of post-traumatic stress after treatment in intensive care. However profound pharmacologically induced sleep is related to long term detrimental consequences. Recent data demonstrate that goal directed, titrated sedation and early rehabilitation can improve patient outcomes, shorten duration of mechanical ventilation, intensive care unit and hospital stay, as well as reduce in mortality and treatment costs. This paper highlights the major recommendations of recent sedation and analgesia guidelines for intensive care. We discuss pharmacology of commonly used sedative and analgesic agents as well as implementation of the guidelines to clinical practice.

Keyword(s): sedation; analgesia; agitation; intensive care.
DOI: 10.5200/sm-hs.2016.116
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