Multidisciplinary management of sedation and analgesia in critical care

被引:92
作者
Sessler, CN
Grap, MJ
Brophy, GM
机构
[1] Virginia Commonwealth Univ, Med Coll Virginia Hosp, Div Pulm & Crit Care Med, Richmond, VA 23298 USA
[2] Virginia Commonwealth Univ, Med Coll Virginia Hosp, Sch Nursing, Richmond, VA 23298 USA
[3] Virginia Commonwealth Univ, Med Coll Virginia Hosp, Sch Pharm, Richmond, VA 23298 USA
关键词
sedation; analgesia; guidelines;
D O I
10.1055/s-2001-13834
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Management of sedation and analgesia in critical care medicine is a multidisciplinary process that involves physicians, nurses, pharmacists, and other healthcare providers. Optimal management of these common issues includes recognition of the importance of predisposing and causative conditions that contribute to the sensations of pain and discomfort, anxiety, and delirium. Treatment includes pharmacological intervention, correction of predisposing factors, and use of other preventative and nonpharmacological measures. It is increasingly clear that, although necessary for patient comfort, sedative and analgesic medications can have adverse consequences, including side-effects as well as prolonged mechanical ventilation and ICU length of stay. Optimal use of sedative and analgesic medications involves matching unique properties of specific medications with individual patient characteristics. Guidelines that minimize unnecessary variability in practice, prevent excessive medication, and emphasize management based on individual patient characteristics improve the effective utilization of these medications.
引用
收藏
页码:211 / 225
页数:15
相关论文
共 102 条
[81]   Propofol versus midazolam: Safety and efficacy for sedating the severe trauma patient [J].
Sanchez-Izquierdo-Riera, JA ;
Caballero-Cubedo, RE ;
Perez-Vela, JL ;
Ambros-Checa, A ;
Cantalapiedra-Santiago, JA ;
Alted-Lopez, E .
ANESTHESIA AND ANALGESIA, 1998, 86 (06) :1219-1224
[82]   CLINICAL ANTECEDENTS TO IN-HOSPITAL CARDIOPULMONARY ARREST [J].
SCHEIN, RMH ;
HAZDAY, N ;
PENA, M ;
RUBEN, BH ;
SPRUNG, CL .
CHEST, 1990, 98 (06) :1388-1392
[83]   Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome [J].
Schelling, G ;
Stoll, C ;
Haller, M ;
Briegel, J ;
Manert, W ;
Hummel, T ;
Lenhart, A ;
Heyduck, M ;
Polasek, J ;
Meier, M ;
Preuss, U ;
Bullinger, M ;
Schüffel, R ;
Peter, K .
CRITICAL CARE MEDICINE, 1998, 26 (04) :651-659
[84]  
SESSLER CN, 2000, AM J RESP CRIT CARE, V161, pA506
[85]  
SESSLER CN, 1992, CHEST, V102, pS192
[86]  
Sessler CN, 1994, J CRIT ILLNESS, V9, P609
[87]  
Sessler Curtis N., 2000, Chest, V118, p95S
[88]   PRACTICE PARAMETERS FOR INTRAVENOUS ANALGESIA AND SEDATION FOR ADULT PATIENTS IN THE INTENSIVE-CARE UNIT - AN EXECUTIVE SUMMARY [J].
SHAPIRO, BA ;
WARREN, J ;
EGOL, AB ;
GREENBAUM, DM ;
JACOBI, J ;
NASRAWAY, SA ;
SCHEIN, RM ;
SPEVETZ, A ;
STONE, JR .
CRITICAL CARE MEDICINE, 1995, 23 (09) :1596-1600
[89]   Torsades de pointes associated with intravenous haloperidol in critically ill patients [J].
Sharma, ND ;
Rosman, HS ;
Padhi, ID ;
Tisdale, JE .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 81 (02) :238-240
[90]  
SHELLY MP, 1991, EUR J ANAESTH, V8, P21