Optimizing evidence-based ICU sedation

摘要

The evidence for sedation protocols in the management of ICU patients requiring mechanical ventilation is robust. Such protocols are associated with numerous benefits, including reduced ventilator days and length of stay (1-3), reduced ICU-related complications (4) and tests to assess for altered mental status (1), and reduced posttrau-matic stress disorder (5), tracheostomy rates (3), and even 1-year mortality (2). Because of this robust evidence, there are strong recommendations for use of a sedation protocol in the management of all sedated ICU patients. Indeed, the recently published article by Barr et al (6) speaks to the importance of using a sedation algorithm for all patients. In spite of the convincing evidence for the use of such algorithms, adoption in many ICUs has been slow (7).