title: A web-based survey of United Kingdom sedation practice in the intensive care unit.
abstract: OBJECTIVE
  The purpose of this work was to obtain a detailed perspective of sedation practice. Sedation included sedative and opioid choice, presence of local guidelines, and use of scoring systems.
  
  
  METHODS
  A Web-based survey was designed. The aim was to gain sufficient detail of UK sedation while also being succinct enough to complete in 15 minutes. It was composed of relevant demographics, policy, sedative choice, and analgesia. The survey was piloted before launch. The investigators selected the intensive care unit (ICU) pharmacist as the respondent.
  
  
  RESULTS
  One hundred fifty-seven ICUs responded. Eighty-nine (59%) reported use of sedation guidelines, 78% undertook sedation holds, and 87% use sedation scores. Only 42% used a daily sedation target. Seventy (43%) assess for delirium; 27 of those use a validated tool. Propofol (89%) use was common, followed by midazolam (49%). Morphine (49%), fentanyl (34%), and alfentanil (34%) were the most frequently used opioids.
  
  
  CONCLUSIONS
  This survey confirmed expected variation in UK sedation practice. Recognized strategies such as target sedation score and sedation policy are underused. A 43% uptake in delirium screening suggests that larger engagement is required to meet national standards.
authors.affiliation: Institute of Pharmaceutical Sciences, Franklin-Wilkins Building, Kings College, London, SE1 7RT, UK; Pharmacy and Critical Care Guys and St Thomas' NHS Foundation Trust (GSTFT), St Thomas' Hospital, London, SE1 7EH, UK.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Yassin
authors.affiliation: School of Medicine, Guys Campus, King's College, London, SE1 9RT, UK; Pharmacy and Critical Care Guys and St Thomas' NHS Foundation Trust (GSTFT), St Thomas' Hospital, London, SE1 7EH, UK.
authors.forename: Marius
authors.initials: M
authors.lastname: Terblanche
authors.affiliation: Department of Critical Care, Royal Sussex County Hospital, Brighton, BN2 5BE, UK.
authors.forename: James
authors.initials: J
authors.lastname: Yassin
authors.affiliation: Institute of Pharmaceutical Sciences, Franklin-Wilkins Building, Kings College, London, SE1 7RT, UK; Pharmacy and Critical Care Guys and St Thomas' NHS Foundation Trust (GSTFT), St Thomas' Hospital, London, SE1 7EH, UK. Electronic address: Catherine.mckenzie@gstt.nhs.uk.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McKenzie
mesh_terms: D015760:Alfentanil / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016292:Procedural Sedation / Q000379:methods*; D003422:Critical Care / Q000379:methods*; D003625:Data Collection; D054810:Deep Sedation / Q000379:methods*; D003693:Delirium / Q000175:diagnosis*; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007362:Intensive Care Units; D020407:Internet; D008874:Midazolam; D009020:Morphine / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015742:Propofol / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D009020:Morphine; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol
keywords: Delirium; Intensive care; Midazolam; Morphine; Propofol; Sedation