title: Sedation assessment in critically ill adults.
abstract: OBJECTIVE
  To review methods for assessing sedation in critically ill adults, discuss their impact on patient outcomes, and provide recommendations for implementing these methods into clinical practice in the intensive care unit (ICU).
  
  
  METHODS
  A computerized search of MEDLINE from 1980 through June 2000 and a manual search of abstracts presented at recent critical care meetings were performed.
  
  
  METHODS
  Sedation assessment tools that have been used to titrate therapy in adult, critically ill patients were identified. Special emphasis was placed on sedation assessment instruments that have been prospectively validated. Objective methods that have been used to assess sedation therapy were also identified.
  
  
  RESULTS
  Twenty-three adult sedation assessment instruments were identified. Few scales have been prospectively evaluated for validity (n = 6) or reliability (n = 7). Other methods of sedation assessment were identified (e.g., bispectral index monitor); however, most of these methods have only been studied in small subsets of critically ill patients.
  
  
  CONCLUSIONS
  Incorporation of sedation assessment into ICU clinical practice may improve patient care. These sedation assessment instruments must be further evaluated to determine their impact on quality of care and ICU length of stay.
authors.affiliation: Department of Pharmacy Services, Detroit Receiving Hospital, University Health Center, 4201 St. Antoine Blvd., Detroit, MI 48201-2403, USA. jdevlin@dmc.org
authors.forename: J W
authors.initials: JW
authors.lastname: Devlin
authors.forename: G L
authors.initials: GL
authors.lastname: Fraser
authors.forename: S
authors.initials: S
authors.lastname: Kanji
authors.forename: R R
authors.initials: RR
authors.lastname: Riker
mesh_terms: D000328:Adult; D016292:Procedural Sedation; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011787:Quality of Health Care; D015203:Reproducibility of Results