Sedation and Analgesia in the Mechanically Ventilated Patient

被引:126
作者
Patel, Shruti B. [1 ]
Kress, John P. [1 ]
机构
[1] Univ Chicago, Dept Med, Sect Pulm & Crit Care, Chicago, IL 60637 USA
关键词
conscious sedation; analgesia; delirium; respiratory insufficiency; benzodiazepines; INTENSIVE-CARE-UNIT; CRITICALLY-ILL PATIENTS; CONFUSION ASSESSMENT METHOD; LONG-TERM SEDATION; DELIRIUM SCREENING CHECKLIST; ANESTHETIC-CONSERVING-DEVICE; CLINICAL-PRACTICE GUIDELINES; PROPOFOL-INFUSION; RANDOMIZED-TRIAL; DOUBLE-BLIND;
D O I
10.1164/rccm.201102-0273CI
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Sedation and analgesia are important components of care for the mechanically ventilated patient in the intensive care unit (ICU). An understanding of commonly used medications is essential to formulate a sedation plan for individual patients. The specific physiological changes that a critically ill patient undergoes can have direct effects on the pharmacology of drugs, potentially leading to interpatient differences in response. Objective assessments of pain, sedation, and agitation have been validated for use in the ICU for assessment and titration of medications. An evidence-based strategy for administering these drugs can lead to improvements in short- and long-term outcomes for patients. In this article, we review advances in the field of ICU sedation to provide an up-to-date perspective on management of the mechanically ventilated ICU patient.
引用
收藏
页码:486 / 497
页数:12
相关论文
共 166 条
[1]   Comparison of different pain scoring systems in critically ill patients in a general ICU [J].
Ahlers, Sabine J. G. M. ;
van Gulik, Laura ;
van der Veen, Aletta M. ;
van Dongen, Hendricus P. A. ;
Bruins, Peter ;
Belitser, Svetlana V. ;
de Boer, Anthonius ;
Tibboel, Dick ;
Knibbe, Catherijne A. J. .
CRITICAL CARE, 2008, 12 (01)
[2]   COMPARISON OF PROPOFOL AND MIDAZOLAM FOR SEDATION IN CRITICALLY ILL PATIENTS [J].
AITKENHEAD, AR ;
WILLATTS, SM ;
PARK, GR ;
COLLINS, CH ;
LEDINGHAM, IM ;
PEPPERMAN, ML ;
COATES, PD ;
BODENHAM, AR ;
SMITH, MB ;
WALLACE, PGM .
LANCET, 1989, 2 (8665) :704-709
[3]   Short-term infusion of the μ-opioid agonist remifentanil in humans causes hyperalgesia during withdrawal [J].
Angst, MS ;
Koppert, W ;
Pahl, I ;
Clark, DJ ;
Schmelz, M .
PAIN, 2003, 106 (1-2) :49-57
[4]   Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial [J].
Anifantaki, Stella ;
Prinianakis, Georgios ;
Vitsaksaki, Efsevia ;
Katsouli, Victoria ;
Mari, Stella ;
Symianakis, Antonios ;
Tassouli, Georgia ;
Tsaka, Eleni ;
Georgopoulos, Dimitris .
JOURNAL OF ADVANCED NURSING, 2009, 65 (05) :1054-1060
[5]  
[Anonymous], 2011, GOODMAN GILMANS PHAR
[6]   Practical Pharmacologic aspects of therapeutic hypothermia after cardiac arrest [J].
Arpino, Paul A. ;
Greer, David M. .
PHARMACOTHERAPY, 2008, 28 (01) :102-111
[7]   Prevention of Intraoperative Awareness in a High-Risk Surgical Population [J].
Avidan, Michael S. ;
Jacobsohn, Eric ;
Glick, David ;
Burnside, Beth A. ;
Zhang, Lini ;
Villafranca, Alex ;
Karl, Leah ;
Kamal, Saima ;
Torres, Brian ;
O'Connor, Michael ;
Evers, Alex S. ;
Gradwohl, Stephen ;
Lin, Nan ;
Palanca, Ben J. ;
Mashour, George A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (07) :591-600
[8]   Outcomes Associated With Delirium in Older Patients in Surgical ICUs [J].
Balas, Michele C. ;
Happ, Mary Beth ;
Yang, Wei ;
Chelluri, Lakshmipathi ;
Richmond, Therese .
CHEST, 2009, 135 (01) :18-25
[9]   Prolonged sedation of critically ill patients with midazolam or propofol: Impact on weaning and costs [J].
BarrientosVega, R ;
SanchezSoria, MM ;
MoralesGarcia, C ;
RobasGomez, A ;
CuenaBoy, R ;
AyensaRincon, A .
CRITICAL CARE MEDICINE, 1997, 25 (01) :33-40
[10]   PROLONGED SEDATION DUE TO ACCUMULATION OF CONJUGATED METABOLITES OF MIDAZOLAM [J].
BAUER, TM ;
RITZ, R ;
HABERTHUR, C ;
HA, HR ;
HUNKELER, W ;
SLEIGHT, AJ ;
SCOLLOLAVIZZARI, G ;
HAEFELI, WE .
LANCET, 1995, 346 (8968) :145-147