Current sedation practices: lessons learned from international surveys.
Patient outcomes are significantly influenced by the choice of sedative and analgesic agents, the presence of over- or undersedation, poor pain control, and delirium. Individualized sedation management using sedation assessment tools, sedation protocols, and daily sedative interruption can improve clinical outcomes. Despite the publication of randomized trials and numerous guidelines, the uptake of proven strategies into routine practice can be slow. Surveys of clinicians' self-reported practice and prospective practice audits characterize sedation and analgesia practices and provide directions for education and future research. The objective of this review is to present the findings of surveys and practice audits, evaluating the management of sedation and analgesia in mechanically ventilated adults in the intensive care unit, and to summarize international critical care sedation practices.
Mehta
Sangeeta
S
Medical Surgical Intensive Care Unit, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada. geeta.mehta@utoronto.ca
McCullagh
Iain
I
Burry
Lisa
L
D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D016292:Procedural Sedation / Q000379:methods*; D003422:Critical Care / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control
D000700:Analgesics; D006993:Hypnotics and Sedatives