title: Sedation in the intensive care unit.
abstract: Analgesics and sedatives are commonly prescribed in the ICU environment for patient comfort, however, recent studies have shown that these medications can themselves lead to adverse patient outcomes. Interventions that facilitate a total dose reduction in analgesic and sedative medications e.g. the use of nurse controlled protocol guided sedation, the combination of spontaneous awakening and breathing trials, and the use of short acting medications, are associated with improved outcomes such as decreased time of mechanical ventilation and ICU length of stay. This purpose of this review is to provide an overview of the pharmacology of commonly prescribed analgesics and sedatives, and to discuss the evidence regarding best prescribing practices of these medications, to facilitate early liberation from mechanical ventilation and to promote animation in critically ill patients.
authors.affiliation: Department of Anesthesiology and Critical Care, Vanderbilt University School of Medicine, Nashville, TN 37212, USA.
authors.forename: S
authors.initials: S
authors.lastname: McGrane
authors.forename: P P
authors.initials: PP
authors.lastname: Pandharipande
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use; D016292:Procedural Sedation / Q000379:methods* / Q000451:nursing; D056805:Consciousness Monitors; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D054810:Deep Sedation / Q000379:methods* / Q000451:nursing; D003693:Delirium / Q000139:chemically induced / Q000517:prevention & control; D016903:Drug Monitoring; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use; D007362:Intensive Care Units; D007902:Length of Stay; D015337:Multicenter Studies as Topic; D017410:Practice Guidelines as Topic; D011595:Psychomotor Agitation / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D012720:Severity of Illness Index
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives