A multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation

Mehta, Sangeeta; Meade, Maureen O.; Hynes, Patricia; Filate, Woganee A; Burry, Lisa; Hallett, David; McDonald, Ellen; Cook, Deborah J.

doi:10.1016/j.jcrc.2006.11.006

Cited by 29 publications

(12 citation statements)

References 9 publications

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“…(11-13) Surveys performed in different countries have shown conflicting results between ICU physicians' and nurses' perceptions of care and actual bedside practice. (14,15) In the present article, we present a narrative, non-systematic review to discuss the main advances in sedation research over the past 10 years and their impact on the care of critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Righy¹,

Salluh²

2013

Revista Brasileira De Terapia Intensiva

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A significant number of landmark studies have been published in the last decade that increase the current knowledge on sedation for critically ill patients. Therefore, many practices that were considered standard of care are now outdated. Oversedation has been shown to be hazardous, and light sedation and no-sedation protocols are associated with better patient outcomes. Delirium is increasingly recognized as a major form of acute brain dysfunction that is associated with higher mortality, longer duration of mechanical ventilation and longer lengths of stay in the intensive care unit and hospital. Despite all the available evidence, translating research into bedside care is a daunting task. International surveys have shown that practices such as sedation interruption and titration are performed only in the minority of cases. Implementing best practices is a major challenge that must also be addressed in the new guidelines. In this review, we summarize the findings of sedation and delirium research over the last years. We also discuss the gap between evidence and clinical practice and highlight ways to implement best practices at the bedside.

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Section: Introductionmentioning

confidence: 99%

Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Righy¹,

Salluh²

2013

Revista Brasileira De Terapia Intensiva

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“…The goal of lighter sedation has existed since the 1990s with the use of validated sedation scoring instruments in protocols or guidelines being central to this goal (Magarey, 1997). Nevertheless, more than a decade later, multi-centre surveys demonstrate wide variation in adoption of protocols, care pathways or guidelines for sedatives or analgesics among countries, for example: Canada 29% (Mehta et al, 2007), the USA 64% (Tanios et al, 2009), and the European countries of France 36% (Payen et al, 2007), Denmark 44% (Egerod et al, 2006), Germany 52% (Martin et al, 2006) and the United Kingdom 80% (Reschreiter et al, 2008). The last European sedation survey was conducted by physicians in 2001 (Soliman et al, 2001).…”

mentioning

confidence: 99%

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

Egerod

Albarran

Ring

et al. 2013

Nursing in Critical Care

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“…[1218] However, the optimal strategy in sedation management is still controversial and differs widely. [22232425262728]…”

Section: Introductionmentioning

confidence: 99%

The benefit of benzodiazepine reduction: Improving sedation in surgical intensive care

Schneider

Puetz

Vassiliou

et al. 2017

Indian Journal of Critical Care Medicine

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Aims:Sedation, as it is often required in critical care, is associated with immobilization, prolonged ventilation, and increased morbidity. Most sedation protocols are based on benzodiazepines. The presented study analyzes the benefit of benzodiazepine-free sedation.Methods:In 2008, 134 patients were treated according to a protocol using benzodiazepine and propofol (Group 1). In 2009, we introduced a new sedation strategy based on sufentanil, nonsteroidal anti-inflammatory drugs, neuroleptics, and antidepressants, which was applied in 140 consecutive patients (Group 2). Depth of sedation, duration of mechanical ventilation, duration of Intensive Care Unit, and hospital stay were analyzed.Results:Group 1 had both a longer duration of deep sedation (18.7 ± 2.5 days vs. 12.6 ± 1.85 days, P = 0.031) and a longer duration of controlled ventilation (311, 35 ± 32.69 vs. 143, 96 ± 20.76 h, P < 0.0001) than Group 2. Ventilator days were more frequent in Group 1 (653, 66 ± 98.37 h vs. 478, 89 ± 68.92 h, P = 0.128).Conclusions:The benzodiazepine-free sedation protocol has been shown to significantly reduce depth of sedation and controlled ventilation. Additional evidence is needed to ascertain reduction of ventilator days which would not only be of benefit for the patient but also for the hospital Management.

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A multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation

Cited by 29 publications

References 9 publications

Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

The benefit of benzodiazepine reduction: Improving sedation in surgical intensive care

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