Executive Summary of a Focused Update to the Clinical Practice Guidelines for the Prevention and Management of Pain, Anxiety, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Kimberley Lewis^{1

2

3}, Michele C Balas⁴, Joanna L Stollings^{5

6}, Molly McNett⁷, Timothy D Girard⁸, Gerald Chanques⁹, Michelle E Kho^{3

10

11}, Pratik P Pandharipande^{6

12}, Gerald L Weinhouse¹³, Nathan E Brummel¹⁴, Linda L Chlan¹⁵, Makayla Cordoza^{6

16

17}, Jeremiah J Duby¹⁸, Céline Gélinas^{19

20}, Erin L Hall-Melnychuk^{21

22}, Anna Krupp²³, Patricia R Louzon²⁴, Judith A Tate⁷, Bethany Young²⁵, Ron Jennings¹, Anitra Hines¹, Chris Ross¹, Kallirroi Laiya Carayannopoulos^{1

2

3}, J Matthew Aldrich²⁶

Affiliations

¹ Department of Medicine, McMaster University, Hamilton, ON, Canada.
² Department of Health Research, Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
³ Research Institute of St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
⁴ University of Nebraska Medical Center, College of Nursing, Omaha, NE.
⁵ Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN.
⁶ Critical Illness, Brain Dysfunction, and Survivorship Center, Nashville, TN.
⁷ College of Nursing, The Ohio State University, Columbus, OH.
⁸ Center for Research, Investigation, and Systems Modeling of Acute Illness (CRISMA), Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
⁹ Department of Anesthesia & Critical Care Medicine, Saint Eloi Montpellier University Hospital, PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
¹⁰ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
¹¹ Physiotherapy Department, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
¹² Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN.
¹³ Department of Medicine, Brigham and Women's Hospital, Boston, MA.
¹⁴ Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH.
¹⁵ Division of Nursing Research, Department of Nursing, Mayo Clinic, Rochester, MN.
¹⁶ School of Nursing, Vanderbilt University, Nashville, TN.
¹⁷ Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
¹⁸ Department of Pharmacy Services, UC Davis Health (UCDH), Sacramento, CA.
¹⁹ Ingram School of Nursing, McGill University, Montreal, QC, Canada.
²⁰ Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.
²¹ Departments of Trauma Surgery and Critical Care Medicine, Geisinger Medical Center, Danville, PA.
²² Department of Psychiatry, Geisinger Commonwealth School of Medicine, Scranton, PA.
²³ Acute and Critical Care Division, College of Nursing, University of Iowa, Iowa City, IA.
²⁴ Department of Pharmacy, AdventHealth Orlando, Orlando, FL.
²⁵ Department of Nursing, Hospital of the University of Pennsylvania, Philadelphia, PA.
²⁶ Anesthesia and Perioperative Care, Critical Care Medicine, University of California, San Francisco, San Francisco, CA.

PMID: 39982138
DOI: 10.1097/CCM.0000000000006573

Executive Summary of a Focused Update to the Clinical Practice Guidelines for the Prevention and Management of Pain, Anxiety, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Kimberley Lewis et al. Crit Care Med. 2025.

. 2025 Mar 1;53(3):e701-e710.

doi: 10.1097/CCM.0000000000006573. Epub 2025 Feb 21.

Authors

Affiliations

¹ Department of Medicine, McMaster University, Hamilton, ON, Canada.
² Department of Health Research, Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
³ Research Institute of St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
⁴ University of Nebraska Medical Center, College of Nursing, Omaha, NE.
⁵ Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN.
⁶ Critical Illness, Brain Dysfunction, and Survivorship Center, Nashville, TN.
⁷ College of Nursing, The Ohio State University, Columbus, OH.
⁸ Center for Research, Investigation, and Systems Modeling of Acute Illness (CRISMA), Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
⁹ Department of Anesthesia & Critical Care Medicine, Saint Eloi Montpellier University Hospital, PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
¹⁰ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
¹¹ Physiotherapy Department, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
¹² Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN.
¹³ Department of Medicine, Brigham and Women's Hospital, Boston, MA.
¹⁴ Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH.
¹⁵ Division of Nursing Research, Department of Nursing, Mayo Clinic, Rochester, MN.
¹⁶ School of Nursing, Vanderbilt University, Nashville, TN.
¹⁷ Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
¹⁸ Department of Pharmacy Services, UC Davis Health (UCDH), Sacramento, CA.
¹⁹ Ingram School of Nursing, McGill University, Montreal, QC, Canada.
²⁰ Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.
²¹ Departments of Trauma Surgery and Critical Care Medicine, Geisinger Medical Center, Danville, PA.
²² Department of Psychiatry, Geisinger Commonwealth School of Medicine, Scranton, PA.
²³ Acute and Critical Care Division, College of Nursing, University of Iowa, Iowa City, IA.
²⁴ Department of Pharmacy, AdventHealth Orlando, Orlando, FL.
²⁵ Department of Nursing, Hospital of the University of Pennsylvania, Philadelphia, PA.
²⁶ Anesthesia and Perioperative Care, Critical Care Medicine, University of California, San Francisco, San Francisco, CA.

PMID: 39982138
DOI: 10.1097/CCM.0000000000006573

No abstract available

PubMed Disclaimer

Conflict of interest statement

Drs. Balas and Girard received funding from Ceribell. Dr. Balas received funding from the National Heart, Lung, and Blood Institute (NHLBI), the National Institute of Nursing Research, and the National Institute of Child Health and Human Development. Drs. McNett and Girard received funding from the National Institutes of Health (NIH). Dr. McNett received funding from Dexcom and the Patient-Centered Outcomes Research Institute. Dr. Girard received funding from Liberate Medical, Lungpacer, and the Department of Defense. Dr. Kho received funding from Restorative Therapies, the Canada Research Chair in Critical Care Rehabilitation and Knowledge Translation, the Canadian Institutes of Health Research (CIHR), and the Canada Foundation for Innovation. Dr. Weinhouse received funding from UpToDate. Dr. Chlan received funding from the NHLBI (1R01 HL 130881-01), the National Institutes on Aging, and the National Eye Institute (NIH R01AG067631). Dr. Gélinas received funding from the Society of Critical Care Medicine and the SAMDOC Medical Technologies; their institution received funding from the CIHR. Dr. Krupp disclosed she was an invited speaker for Fall 2022 American Association of Nurse Practitioners. Dr. Young received funding from the Southeastern Pennsylvania Chapter of American Association of Critical-Care Nurses. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

1. Elliott D, Davidson JE, Harvey MA, et al.: Exploring the scope of post-intensive care syndrome therapy and care. Crit Care Med 2014; 42:2518–2526
1. Needham DM, Davidson J, Cohen H, et al.: Improving long-term outcomes after discharge from intensive care unit. Crit Care Med 2012; 40:502–509
1. Saltnes-Lillegård C, Rustøen T, Beitland S, et al.: Self-reported symptoms experienced by intensive care unit patients: A prospective observational multicenter study. Intensive Care Med 2023; 49:1370–1382
1. Devlin JW, Skrobik Y, Gélinas C, et al.: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018; 46:e825–e873
1. Barr J, Fraser G, Puntillo K, et al.: 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

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Executive Summary of a Focused Update to the Clinical Practice Guidelines for the Prevention and Management of Pain, Anxiety, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Affiliations

Executive Summary of a Focused Update to the Clinical Practice Guidelines for the Prevention and Management of Pain, Anxiety, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Authors

Affiliations

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources