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Management of sedation in the critically ill 

Management of sedation in the critically ill
Chapter:
Management of sedation in the critically ill
Author(s):

Bhakti K. Patel

and John P. Kress

DOI:
10.1093/med/9780199600830.003.0359
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date: 25 October 2020

Once adequate analgesia is confirmed, the need for sedation should be considered. Sedation of mechanically-ventilated patients is a common challenge in the intensive care unit (ICU). Metabolism of sedatives in critical illness can be unpredictable and achieving optimal sedation without coma is a moving target. Once adequate analgesia is achieved, the choice, depth, and duration of sedation can have major implications for the presence of delirium, the duration of mechanical ventilation, ventilator-associated pneumonia, and ICU length of stay. Therefore, goal-directed titration of sedative and frequent assessment of the depth of sedation is important to strike the delicate balance of patient comfort, while avoiding excessive prolonged sedation.

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