Daily Interruptions of Sedation: A Clinical Approach to Improve Outcomes in Critically Ill Patients

Abstract

Although sedation may provide relief of anxiety and agitation, it is also associated with risks, including delirium, prolonged mechanical ventilation, and longer stays in the ICU and hospital. 4,5 Further, patients receiving sedative infusions can quickly become oversedated or sedated for a prolonged period even after the sedation is discontinued. Despite these risks, the use of continuous sedation is prevalent and has increased over the years. Management of SedationTo lessen the occurrence of these complications, caution in administration of sedatives must be exercised. Thorough assessment and management of anxiety is an important nursing responsibility. In managing the continuous infusion of sedatives, a delicate balance must be maintained between minimizing risks and optimizing delivery of care and comfort. Nurses and acute care nurse practitioners (ACNPs) working in critical care settings will often

The Wicked Question Answered

“…As this study was concluding, literature noted a need for guidelines on turning and repositioning hemodynamically unstable patients, citing a lack of evidence with which to answer this question from literature. Use of sedatives in critically ill patients and current sedation management direction was published based on review of evidence in literature, 17 directly relating to statements produced by the panel, also supporting Less than 50% of the ratings in 1 agreement category or G60% of ratings in 2 contiguous categories the dominant themes of need for better communication and guidelines as well as some decision-making leeway for endof-life care. 13 End-of-life care.…”

Sedation and Its Association With Posttraumatic Stress Disorder After Intensive Care

“…Despite differences in sedation goals, this finding was consistent in all 4 studies I examined and has been incorporated into much of the literature in favor of sedation-interruption protocols. [26][27][28][29] Of note, the study 6 with the smallest sample size, and the only study that included analgosedation, most likely was underpowered to confirm this assertion.…”

Clinical Utility of a Structured Program to Reduce the Risk of Health-Related Quality of Life Impairment after Discharge from Intensive Care Unit: A Real-World Experience

“…Our analgesia protocol was based on a systematic re-evaluation of the intensity of pain, performed three times a day at regular intervals using validated scales [22–24]. For patients able to communicate, the standard Visual Analogue Scale (VAS) was utilized.…”