Ensuring patient comfort in ICU is important.
Most patient’s memory of ICU is dominated by memories of pain.
Adequate ANALGESIA is therefore the first thing that must be ensured.
DELIRIUM – a reversible, acute brain dysfunction – is often brought on by the ICU environment (sleep deprivation is a major factor in causing it), and is exacerbated by pain. The disorders of thinking, and potential for hallucinations, are more reasons for patient suffering.
DEPRESSION is also a debilitating factor.
Only when all the above have been addressed, should the patient receive SEDATION. If the ADD have been appropriately managed, only a minority of patients (those needing neuroprotection, or extreme ventilation, or those with profound neurological or metabolic abnormalities), require deep sedation. For the remainder, light sedation, to a defined target, regularly lightened and re-assessed, is more appropriate.
vraiida 