title: Evidence and consensus-based German guidelines for the management of analgesia, sedation and delirium in intensive care--short version.
abstract: Targeted monitoring of analgesia, sedation and delirium, as well as their appropriate management in critically ill patients is a standard of care in intensive care medicine. With the undisputed advantages of goal-oriented therapy established, there was a need to develop our own guidelines on analgesia and sedation in intensive care in Germany and these were published as 2(nd) Generation Guidelines in 2005. Through the dissemination of these guidelines in 2006, use of monitoring was shown to have improved from 8 to 51% and the use of protocol-based approaches increased to 46% (from 21%). Between 2006-2009, the existing guidelines from the DGAI (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) were developed into 3(rd) Generation Guidelines for the securing and optimization of quality of analgesia, sedation and delirium management in the intensive care unit (ICU). In collaboration with another 10 professional societies, the literature has been reviewed using the criteria of the Oxford Center of Evidence Based Medicine. Using data from 671 reference works, text, diagrams and recommendations were drawn up. In the recommendations, Grade "A" (very strong recommendation), Grade "B" (strong recommendation) and Grade "0" (open recommendation) were agreed. As a result of this process we now have an interdisciplinary and consensus-based set of 3(rd) Generation Guidelines that take into account all critically illness patient populations. The use of protocols for analgesia, sedation and treatment of delirium are repeatedly demonstrated. These guidelines offer treatment recommendations for the ICU team. The implementation of scores and protocols into routine ICU practice is necessary for their success.
authors.affiliation: Department of Anesthesiology and Operative Intensive Care, Klinik am Eichert, Göppingen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Martin
authors.forename: Anja
authors.initials: A
authors.lastname: Heymann
authors.forename: Katrin
authors.initials: K
authors.lastname: Bäsell
authors.forename: Ralf
authors.initials: R
authors.lastname: Baron
authors.forename: Rolf
authors.initials: R
authors.lastname: Biniek
authors.forename: Hartmut
authors.initials: H
authors.lastname: Bürkle
authors.forename: Peter
authors.initials: P
authors.lastname: Dall
authors.forename: Christine
authors.initials: C
authors.lastname: Dictus
authors.forename: Verena
authors.initials: V
authors.lastname: Eggers
authors.forename: Ingolf
authors.initials: I
authors.lastname: Eichler
authors.forename: Lothar
authors.initials: L
authors.lastname: Engelmann
authors.forename: Lars
authors.initials: L
authors.lastname: Garten
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartl
authors.forename: Ulrike
authors.initials: U
authors.lastname: Haase
authors.forename: Ralf
authors.initials: R
authors.lastname: Huth
authors.forename: Paul
authors.initials: P
authors.lastname: Kessler
authors.forename: Stefan
authors.initials: S
authors.lastname: Kleinschmidt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koppert
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Kretz
authors.forename: Heinz
authors.initials: H
authors.lastname: Laubenthal
authors.forename: Guenter
authors.initials: G
authors.lastname: Marggraf
authors.forename: Andreas
authors.initials: A
authors.lastname: Meiser
authors.forename: Edmund
authors.initials: E
authors.lastname: Neugebauer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Neuhaus
authors.forename: Christian
authors.initials: C
authors.lastname: Putensen
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.forename: Alexander
authors.initials: A
authors.lastname: Reske
authors.forename: Bernard
authors.initials: B
authors.lastname: Roth
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Stefan
authors.initials: S
authors.lastname: Schröder
authors.forename: Dierk
authors.initials: D
authors.lastname: Schreiter
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schüttler
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schwarzmann
authors.forename: Robert
authors.initials: R
authors.lastname: Stingele
authors.forename: Peter
authors.initials: P
authors.lastname: Tonner
authors.forename: Philip
authors.initials: P
authors.lastname: Tränkle
authors.forename: Rolf Detlef
authors.initials: RD
authors.lastname: Treede
authors.forename: Tomislav
authors.initials: T
authors.lastname: Trupkovic
authors.forename: Michael
authors.initials: M
authors.lastname: Tryba
authors.forename: Frank
authors.initials: F
authors.lastname: Wappler
authors.forename: Christian
authors.initials: C
authors.lastname: Waydhas
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000698:Analgesia / Q000592:standards*; D016292:Procedural Sedation / Q000592:standards*; D003422:Critical Care / Q000592:standards*; D016638:Critical Illness / Q000628:therapy; D003693:Delirium / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D017410:Practice Guidelines as Topic