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Comment
. 2014 Nov 10;18(6):600.
doi: 10.1186/s13054-014-0600-3.

Early sedation use in critically ill mechanically ventilated patients: when less is really more

Christie M Lee, Sangeeta Mehta
Comment

Early sedation use in critically ill mechanically ventilated patients: when less is really more

Christie M Lee et al. Crit Care. .

Abstract

Over the last 10 years, there has been an explosion of literature surrounding sedation management for critically ill patients. The clinical target has moved away from an unconscious and immobile patient toward a goal of light or no sedation and early mobility. The move away from terms such as 'sedation' toward more patient-centered and symptom-based control of pain, anxiety, and agitation makes the management of critically ill patients more individualized and dynamic. Over-sedation has been associated with negative ICU outcomes, including longer durations of mechanical ventilation and lengths of stay, but few studies have been able to associate deep sedation with increased mortality.

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References

    1. Tanaka LM, Azevedo LC, Park M, Schettino G, Nassar AP, Jr, Réa-Neto A, Tannous L, de Souza-Dantas VC, Torelly A, Lisboa T, Piras C, Carvalho FB, Maia MD, Gianini FP, Machado FR, Dal-Pizzol F, de Carvalho AG, Dos Santos RB, Tierno PF, Soares M, Salluh JI. Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study. Crit Care. 2014;18:R156. doi: 10.1186/cc13995. - DOI - PMC - PubMed
    1. Shehabi Y, Bellomo R, Reade MC, Bailey M, Bass F, Howe B, McArthur C, Seppelt IM, Webb S, Weisbrodt L, Sedation Practice in Intensive Care Evaluation (SPICE) Study Investigators. ANZICS Clinical Trials Group Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med. 2012;186:724–731. doi: 10.1164/rccm.201203-0522OC. - DOI - PubMed
    1. Shehabi Y, Chan L, Kadiman S, Alias A, Ismail WN, Tan MATI, Khoo TM, Ali SB, Saman MA, Shaltut A, Tan CC, Yong CY, Bailey M, Sedation Practice in Intensive Care Evaluation (SPICE) Study Group investigators Sedation depth and long-term mortality in mechanically ventilated critically ill adults: a prospective longitudinal multicentre cohort study. Intensive Care Med. 2013;39:910–918. doi: 10.1007/s00134-013-2830-2. - DOI - PMC - PubMed
    1. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Joffe AM, Coursin DB, Herr DL, Tung A, Robinson BR, Fontaine DK, Ramsay MA, Riker RR, Sessler CN, Pun B, Skrobik Y, Jaeschke R, American College of Critical Care Medicine Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41:263–306. doi: 10.1097/CCM.0b013e3182783b72. - DOI - PubMed
    1. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, Francis J, Speroff T, Gautam S, Margolin R. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS) JAMA. 2003;289:2983–2991. doi: 10.1001/jama.289.22.2983. - DOI - PubMed

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