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Sedation and analgesia in the ICU 

Sedation and analgesia in the ICU
Chapter:
Sedation and analgesia in the ICU
Author(s):

Michael C. Reade

DOI:
10.1093/med/9780198746690.003.0391
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date: 03 March 2021

Patients undergoing mechanical ventilation or other forms of invasive organ support in an intensive care unit should ideally be free of pain, anxiety, and delirium, sufficiently cooperative or sedated to enable safe delivery of essential aspects of their care; sufficiently awake such that tracheal extubation is not unnecessarily delayed; and left with few or no unpleasant memories of their illness and treatment. This ideal is often not achieved. Management should be based on an analgesia-first, delirium-control, sedation-minimization approach. Identifying intensive care unit-associated delirium is not straightforward: most delirious intensive care patients are not agitated, and ‘hypoactive’ delirium can mask substantial psychological distress. Various assessment scales can be used to quantitate, monitor, and communicate sedation and sedation goals, and similar tools can be employed to identify delirium.

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