Sedation in the Critically Ill Patients.

Kim, Tae Hyung

doi:2012.72.2.117

Tuberc Respir Dis > Volume 72(2); 2012 > Article

Review Article

Tuberculosis and Respiratory Diseases 2012;72(2):117-123.
DOI: https://doi.org/10.4046/trd.2012.72.2.117 Published online February 1, 2012.

Sedation in the Critically Ill Patients.

Tae Hyung Kim

Department of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. drterry@hanyang.ac.kr

Abstract

Optimal level of sedation and analgesia is important for the comfort and safety of critically ill patients. However, suboptimal sedation is relatively common in the intensive care unit (ICU) and it could cause prolonged mechanical ventilation and ICU stay, also increase delirium and ICU acquired weakness and resultant decreased survival. Therefore, accurate assessment of the level of sedation and analgesia, maintaining adequate level of sedation, and daily evaluation of each patient and following adjustment could be important treatment strategy in critically ill patients. Recently, the strategy for sedation in the ICU is changing toward the direction of lowering sedation level or even "no sedation" with concurrent use of analgesics and the use of ultra short acting analgesics could be helpful in some patients. Clinicians should be aware of the importance of algorithmic approach including daily interruption of sedative and assessment of sedation level and especially in the patients under mechanical ventilation, organizational approaches such as the 'ABCDE' bundle could improve the management of critically ill patients.

Key Words: Anesthesia, Analgesia, Respiration, Artificial