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Sedation assessment in the critically ill 

Sedation assessment in the critically ill
Sedation assessment in the critically ill

Giovanni Mistraletti

and Gaetano Iapichino

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date: 17 May 2022

Patient comfort is a primary goal in ICU, but achieving and maintaining the appropriate balance of analgesia, sedation, and treatment of delirium is frequently challenging. International guidelines recommend keeping critically-ill patients calm and cooperative, awake in daytime and asleep at night, always avoiding deep sedation. To state the actual level of sedation and the desired one, it is necessary to frequently perform a sedation assessment with validated tools. Subjective methods are the most useful guides in ICU consciously-sedated patients, representing the gold standard for good clinical practice. Use of such a scale is a key component of sedation algorithms. The ideal scoring system should be easy, reliable, sensitive, and with minimal interobserver variability, giving no or minimal additional discomfort to the patient. Most of the proposed tools are a compromise between accuracy and time required for evaluation; the most used are the Richmond Agitation-Sedation Scale and the Sedation-Agitation Scale.

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