ICU sedation

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Background

  • Sedation is commonly used for ICU patients
  • Agent choice determined by side effect profile and disease process

Uses

  • Can control agitation
  • Improves patient-ventilator synchrony
  • Decreases O2 consumption
  • Decrease intracranial pressure in neurosurgical patients

Agents

Adverse Effects

  • Drug and dose dependent, but generally include:
    • Hypotension
    • Respiratory depression
    • Withdrawal
    • Delirium
    • Arrhythmias

Monitoring

  • Several sedation monitoring scales are validated
  • Richmond Agitation and Sedation Scale most commonly used (RASS)
    • Lighter sedation associated with shorter ICU stay, decreased time on ventilator[1]

Considerations

  1. ↑ Jacobi, J., Fraser, G. L., Coursin, D. B., Riker, R. R., Fontaine, D., Wittbrodt, E. T., Chalfin, D. B., Masica, M. F., Bjerke, S. H., Coplin, W. M., Crippen, D. W., Fuchs, B. D., Kelleher, R. M., Marik, P. E., Nasraway, S. A., Murray, M. J., Peruzzi, W. T. and Lumb, P. D. (2002) ‘Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult’, Critical Care Medicine, 30(1), pp. 119–141.
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