Management of agitation and sedation in Critical Units. Any news?
DOI:
https://doi.org/10.30445/rear.v11i11.798Keywords:
critical units, critical patient, sedation, agitationAbstract
We conducted a review of the clinical practice guide for the prevention and management of agitation and sedation in patients admitted to critical units. It is a guide that includes recommendations on five critical patient sections: pain, agitation / sedation, delirium, immobility (mobilization / rehabilitation) and sleep (disruption). We analyzed the recommendations established for the optimal level of sedation, the evaluation and interruption of sedation, the correct choice of sedative and the accompaniment of physical restraint measures.
This guide has been developed by a group of 32 international experts, 4 methodology specialists and 4 critically ill survivors gathered to update and expand the clinical practice guidelines of 2013.
A great agreement was obtained between the opinion of these international experts of the disciplinary differences together with the review of the literature of five electronic databases from 1990 to 2015 to support these recommendations with the highest level of evidence based on the GRADE methodology.
They presented the recommendations with a level of evidence "high", "moderate" or "low", supported and discussed in plenary sessions, approving those that exceeded 80% of the consensus. Among the results obtained, 37 recommendations were issued (3 of high evidence and 34 moderate). The need to improve research on pain, agitation / sedation, delirium, immobility (mobilization / rehabilitation) and sleep (disruption) that provide the basis for the improvement of results in this vulnerable population was highlighted.
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