Sedation in the mechanically ventilated patient

被引:81
作者
Kress, John P. [1 ]
Hall, Jesse B. [1 ]
机构
[1] Univ Chicago, Dept Med, Sect Pulm & Crit Care, Chicago, IL 60637 USA
关键词
conscious sedation; analgesia; respiratory insufficiency; benzodiazepines; opiates; propofol;
D O I
10.1097/01.CCM.0000239117.39890.E3
中图分类号
R4 [临床医学];
学科分类号
1002 [临床医学]; 100602 [中西医结合临床];
摘要
Objective: To discuss the approach to sedation of the mechanically ventilated patient. Data Synthesis: Mechanically ventilated patients in the intensive care unit frequently require sedation and analgesia for anxiety and pain experienced during the time they are intubated. Multiple drugs are available for this purpose. Strategies that optimize comfort while minimizing the predilection for sedative and analgesic drug accumulation with prolongation of effect have been shown to improve outcomes. In particular, such strategies may decrease mechanical ventilation duration, intensive care unit length of stay, and complications associated with critical illness. Conclusions: Sedation and analgesia are important in the management of patients who require mechanical ventilation. An evidence-based approach to administering sedatives and analgesics is necessary to optimize short- and long-term outcomes in mechanically ventilated patients.
引用
收藏
页码:2541 / 2546
页数:6
相关论文
共 87 条
[1]
[Anonymous], SEMIN ANESTH
[2]
PHARMACOKINETICS OF PROPOFOL DURING AND AFTER LONG-TERM CONTINUOUS INFUSION FOR MAINTENANCE OF SEDATION IN ICU PATIENTS [J].
BAILIE, GR ;
COCKSHOTT, ID ;
DOUGLAS, EJ ;
BOWLES, BJM .
BRITISH JOURNAL OF ANAESTHESIA, 1992, 68 (05) :486-491
[3]
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
[4]
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
[5]
Intensive Care Delirium Screening Checklist: evaluation of a new screening tool [J].
Bergeron, N ;
Dubois, MJ ;
Dumont, M ;
Dial, S ;
Skrobik, Y .
INTENSIVE CARE MEDICINE, 2001, 27 (05) :859-864
[6]
Use of in vitro and in vivo data to estimate the likelihood of metabolic pharmacokinetic interactions [J].
Bertz, RJ ;
Granneman, GR .
CLINICAL PHARMACOKINETICS, 1997, 32 (03) :210-258
[7]
BIANCHI M, 1993, ARCH INT PHARMACOD T, V322, P5
[8]
THE ALTERED PHARMACOKINETICS AND PHARMACODYNAMICS OF DRUGS COMMONLY USED IN CRITICALLY ILL PATIENTS [J].
BODENHAM, A ;
SHELLY, MP ;
PARK, GR .
CLINICAL PHARMACOKINETICS, 1988, 14 (06) :347-373
[9]
Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation [J].
Brook, AD ;
Ahrens, TS ;
Schaiff, R ;
Prentice, D ;
Sherman, G ;
Shannon, W ;
Kollef, MH .
CRITICAL CARE MEDICINE, 1999, 27 (12) :2609-2615
[10]
NEUROLEPTIC MALIGNANT SYNDROME IN A TRAUMA PATIENT [J].
BURKE, C ;
FULDA, GJ ;
CASTELLANO, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1995, 39 (04) :796-798