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Review
. 2023 Jul 27;13(8):1194.
doi: 10.3390/jpm13081194.

Sedation and Analgesia for Toxic Epidermal Necrolysis in the Intensive Care Unit: Few Certainties, Many Questions Ahead

Eduardo Kattan  1 , Maria Francisca Elgueta  2 , Sebastian Merino  3 , Jaime Retamal  1   4
Affiliations
Review

Sedation and Analgesia for Toxic Epidermal Necrolysis in the Intensive Care Unit: Few Certainties, Many Questions Ahead

Eduardo Kattan et al. J Pers Med. .

Abstract

Toxic epidermal necrolysis (TEN) is a rare, acute mucocutaneous life-threatening disease. Although research has focused on the pathophysiological and therapeutic aspects of the disease, there is a paucity of data in the literature regarding pain management and sedation in the intensive care unit (ICU). Most therapies have been extrapolated from other situations and/or the general ICU population. These patients present unique challenges during the progression of the disease and could end up requiring invasive mechanical ventilation due to inadequate pain management, which is potentially avoidable through a comprehensive treatment approach. In this review, we will present clinical and pathophysiological aspects of TEN, analyze pain pathways and relevant pharmacology, and propose therapeutic alternatives based on a rational and multimodal approach.

Keywords: critical care; intensive care unit; pain; sedation; toxic epidermal necrolysis.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Integrated scheme of pain pathways.
Figure 2
Figure 2
Schematic representation of toxic epidermal necrolysis’s pain evolution and characterization through time.
Figure 3
Figure 3
Proposed multimodal therapeutic algorithm.
See this image and copyright information in PMC

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