The incidence of sub-optimal sedation in the ICU: A systematic review

Critical Care

Volumn 13, Issue 6, 2009, Pages

  Jackson, Daniel L ^a   Proudfoot, Clare W ^b   Cann, Kimberley F ^b   Walsh, Tim S ^c  

^a GE HEALTHCARE   (United Kingdom)

^b Heron Evidence Development Ltd   (United Kingdom)

^c ROYAL INFIRMARY OF EDINBURGH   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

HYPNOTIC SEDATIVE AGENT;

HUMAN; INCIDENCE; INTENSIVE CARE; INTENSIVE CARE UNIT; META ANALYSIS; PATIENT SELECTION; REVIEW;

CRITICAL CARE; HUMANS; HYPNOTICS AND SEDATIVES; INCIDENCE; INTENSIVE CARE UNITS; META-ANALYSIS AS TOPIC; PATIENT SELECTION;

EID: 77951633063     PISSN: 13648535     EISSN: 1466609X     Source Type: Journal    
DOI: 10.1186/cc8212     Document Type: Article

References (62)

1. Fraser GL, Riker RR. Comfort without coma: changing sedation practices. Crit Care Med 2007, 35:635-637. 10.1097/01.CCM.0000254072.83323.4E, 17251707.
2. Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, Chalfin DB, Masica MF, Bjerke HS, Coplin WM, Crippen DW, Fuchs BD, Kelleher RM, Marik PE, Nasraway SA, Murray MJ, Peruzzi WT, Lumb PD,. Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), American Society of Health-System Pharmacists (ASHP), American College of Chest Physicians Clinical practice guidelines for the sustained use of sedative and analgesics in the critically ill adult. Crit Care Med 2002, 30:119-141. 10.1097/00003246-200201000-00020, 11902253, Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), American Society of Health-System Pharmacists (ASHP), American College of Chest Physicians.
3. Tallgren M, Pettila V, Hynninen M, Tallgren M, Pettila V, Hynninen M. Quality assessment of sedation in intensive care. Acta Anaesthesiol Scand 2006, 50:942-946. 10.1111/j.1399-6576.2006.01094.x, 16923088.
4. Carrasco G. Instruments for monitoring intensive care unit sedation. Crit Care 2000, 4:217-225. 10.1186/cc697, 150039, 11094504.
5. Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation. Chest 1998, 114:541-548. 10.1378/chest.114.2.541, 9726743.
6. Martin J, Franck M, Sigel S, Weiss M, Spies C. Changes in sedation management in German intensive care units between 2002 and 2006: a national follow-up survey. Crit Care 2007, 11:R124. 10.1186/cc6189, 2246220, 18062820.
7. De Jonghe B, Cook D, Appere-De-Vecchi C, Guyatt G, Meade M, Outin H. Using and understanding sedation scoring systems: a systematic review. Intensive Care Med 2000, 26:275-285. 10.1007/s001340051150, 10823383.
8. Pun BT, Dunn J. The sedation of critically ill adults: Part 1: Assessment. The first in a two-part series focuses on assessing sedated patients in the ICU. Am J Nurs 2007, 107:40-48.
9. Vivien B, Di MS, Ouattara A, Langeron O, Coriat P, Riou B. Overestimation of Bispectral Index in sedated intensive care unit patients revealed by administration of muscle relaxant. Anesthesiology 2003, 99:9-17. 10.1097/00000542-200307000-00006, 12826836.
10. Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS. Anesthesia awareness and the bispectral index. N Engl J Med 2008, 358:1097-1108. 10.1056/NEJMoa0707361, 18337600.
11. University of Virginia Health System Adult critical care sedation guideline. 2005, Charlottesville, VA: Rector and Board of Visitors of the University of Virginia, University of Virginia Health System., http://www.healthsystem.virginia.edu/internet/e-learning/sedguide.pdf.
12. Mattia C, Savoia G, Paoletti F, Piazza O, Albanese D, Amantea B, Ambrosio F, Belfiore B, Berti M, Bertini L, Bruno F, Carassiti M, Celleno D, Coluzzi F, Consales G, Costantini A, Cuppini F, De Gaudio RA, Farnia A, Finco G, Gravino E, Guberti A, Laurenzi L, Mangione S, Marano M, Mariconda G, Martorano PP, Mediati R, Mercieri M, Mondello E, et al. SIAARTI recommendations for analgo-sedation in intensive care unit. Minerva Anestesiol 2006, 72:769-805.
13. Knape JT, Adriaensen H, van Aken H, Blunnie WP, Carlsson C, Dupont M, Pasch T,. Board of Anaesthesiology of the European Union of Medical Specialists Guidelines for sedation and/or analgesia by non-anaesthesiology doctors. Eur J Anaesthesiol 2007, 24:563-567. 10.1017/S0265021506002092, 17568472, Board of Anaesthesiology of the European Union of Medical Specialists.
14. University of Pennsylvania Medical Center Clinical practice guideline manual: analgesia and sedation in the ICU. 2003, University of Pennsylvania Medical Center., http://www.uphs.upenn.edu/surgery/trauma/scc/protocol/Analgesia.pdf.
15. Shapiro BA, Warren J, Egol AB, Greenbaum DM, Jacobi J, Nasraway SA, Schein RM, Spevetz A, Stone JR. Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit: an executive summary. Society of Critical Care Medicine. Crit Care Med 1995, 23:1596-1600. 10.1097/00003246-199509000-00021, 7664563.
16. American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharmacists, American College of Chest Physicians Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Am J Health Syst Pharm 2002, 59:150-178. American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharmacists, American College of Chest Physicians.
17. Feeley K, Gardner A. Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice. Aust Crit Care 2006, 19:73-77. 10.1016/S1036-7314(06)80012-3, 16764155.
18. Shapiro MB, West MA, Nathens AB, Harbrecht BG, Moore FA, Bankey PE, Freeman B, Johnson JL, McKinley BA, Minei JP, Moore EE, Maier RV,. Inflammation and the Host Response to Injury Large Scale Collaborative Research Project V. Guidelines for sedation and analgesia during mechanical ventilation general overview. J Trauma 2007, 63:945-950. 10.1097/TA.0b013e318142d21b, 18090028, Inflammation and the Host Response to Injury Large Scale Collaborative Research Project.
19. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL, et al. International Surviving Sepsis Campaign Guidelines Committee; American Association of Critical-Care Nurses; American College of Chest Physicians; American College of Emergency Physicians; Canadian Critical Care Society; European Society of Clinical Microbiology and Infectious Diseases Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008, 36:296-327. 10.1097/01.CCM.0000298158.12101.41, 18158437, International Surviving Sepsis Campaign Guidelines Committee; American Association of Critical-Care Nurses; American College of Chest Physicians; American College of Emergency Physicians; Canadian Critical Care Society; European Society of Clinical Microbiology and Infectious Diseases.
20. Scottish Intercollegiate Guidance Network Methodology - search filters. Accessed 2008, Scottish Intercollegiate Guidance Network., http://www.sign.ac.uk/methodology/filters.html.
21. Millane TA, Bennett ED, Grounds RM. Isoflurane and propofol for long-term sedation in the intensive care unit: a crossover study. Anaesthesia 1992, 47:768-774. 10.1111/j.1365-2044.1992.tb03254.x, 1415973.
22. Carson SS, Kress JP, Rodgers JE, Vinayak A, Campbell-Bright S, Levitt J, Bourdet S, Ivanova A, Henderson AG, Pohlman A, Chang L, Rich PB, Hall J. A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients. [See comment]. Crit Care Med 2006, 34:1326-1332. 10.1097/01.CCM.0000215513.63207.7F, 16540958.
23. McCollam JS, O'Neil MG, Norcross ED, Byrne TK, Reeves ST. Continuous infusions of lorazepam, midazolam, and propofol for sedation of the critically ill surgery trauma patient: a prospective, randomized comparison. [See comment]. Crit Care Med 1999, 27:2454-2458. 10.1097/00003246-199911000-00022, 10579264.
24. Shehabi Y, Ruettimann U, Adamson H, Innes R, Ickeringill M. Dexmedetomidine infusion for more than 24 hours in critically ill patients: sedative and cardiovascular effects. Intensive Care Med 2004, 30:2188-2196. 10.1007/s00134-004-2417-z, 15338124.
25. Harper SJ, Buckley PM, Carr K, Harper SJ, Buckley PM, Carr K. Propofol and alfentanil infusions for sedation in intensive therapy. Eur J Anaesthesiol 1991, 8:157-165.
26. Carrasco G, Molina R, Costa J, Soler JM, Cabre L. Propofol vs midazolam in short-, medium-, and long-term sedation of critically ill patients. A cost-benefit analysis. Chest 1993, 103:557-564. 10.1378/chest.103.2.557, 8432154.
27. Roustan JP, Valette S, Aubas P, Rondouin G, Capdevila X. Can electroencephalographic analysis be used to determine sedation level in critically ill patients?. Anesth Analg 2005, 101:1141-1151. table of contents, 10.1213/01.ane.0000167782.47957.e1, 16192535.
28. Hernández-Gancedo C, Pestaña D, Peña N, Royo C, Pérez-Chrzanowska H, Criado A. Monitoring sedation in critically ill patients: bispectral index, Ramsay and observer scales. Eur J Anaesthesiol 2006, 23:649-653. 10.1017/S0265021506000056, 16438768.
29. Barrientos-Vega R, Sánchez-Soria MM, Morales-Garcia C, Cuena-Boy R, Castellano-Hernández M. Pharmacoeconomic assessment of propofol 2% used for prolonged sedation. Crit Care Med 2001, 29:317-322. 10.1097/00003246-200102000-00018, 11246312.
30. Martin J, Franck M, Fischer M, Spies C. Sedation and analgesia in German intensive care units: how is it done in reality? Results of a patient-based survey of analgesia and sedation. Intensive Care Med 2006, 32:1137-1142. 10.1007/s00134-006-0214-6, 16741692.
31. Anis AH, Wang XH, Leon H, Hall R,. Propofol Study Group Economic evaluation of propofol for sedation of patients admitted to intensive care units. Anesthesiology 2002, 96:196-201. 10.1097/00000542-200201000-00034, 11753021, Propofol Study Group.
32. Cigada M, Pezzi A, Di Mauro P, Marzorati S, Noto A, Valdambrini F, Zaniboni M, Astori M, Iapichino G. Sedation in the critically ill ventilated patient: possible role of enteral drugs. Intensive Care Med 2005, 31:482-486. 10.1007/s00134-005-2559-7, 15714324.
33. Finfer SR, O'Connor AM, Fisher MM. A prospective randomised pilot study of sedation regimens in a general ICU population: a reality-based medicine study. Crit Care 1999, 3:79-83. 10.1186/cc344, 29018, 11056728.
34. Barr J, Zomorodi K, Bertaccini EJ, Shafer SL, Geller E. A double-blind, randomized comparison of i.v. lorazepam versus midazolam for sedation of ICU patients via a pharmacologic model. [See comment]. Anesthesiology 2001, 95:286-298. 10.1097/00000542-200108000-00007, 11506097.
35. MacLaren R, Plamondon JM, Ramsay KB, Rocker GM, Patrick WD, Hall RI. A prospective evaluation of empiric versus protocol-based sedation and analgesia. Pharmacotherapy 2000, 20:662-672. 10.1592/phco.20.7.662.35172, 10853622.
36. Sandiumenge Camps A, Sanchez-Izquierdo Riera JA, Toral Vazquez D, Sa Borges M, Peinado Rodriguez J, Alted Lopez E. Midazolam and 2% propofol in long-term sedation of traumatized critically ill patients: efficacy and safety comparison. Crit Care Med 2000, 28:3612-3619. 10.1097/00003246-200011000-00009, 11098962.
37. Richman PS, Baram D, Varela M, Glass PS. Sedation during mechanical ventilation: a trial of benzodiazepine and opiate in combination. Crit Care Med 2006, 34:1395-1401. 10.1097/01.CCM.0000215454.50964.F8, 16540957.
38. McMurray TJ, Johnston JR, Milligan KR, Grant IS, Mackenzie SJ, Servin F, Janvier G, Glen JB. Propofol sedation using Diprifusor target-controlled infusion in adult intensive care unit patients. Anaesthesia 2004, 59:636-641. 10.1111/j.1365-2044.2004.03745.x, 15200536.
39. Karabinis A, Mandragos K, Stergiopoulos S, Komnos A, Soukup J, Speelberg B, Kirkham AJ. Safety and efficacy of analgesia-based sedation with remifentanil versus standard hypnotic-based regimens in intensive care unit patients with brain injuries: a randomised, controlled trial. Crit Care 2004, 8:R268-R280. 10.1186/cc2896, 522854, 15312228.
40. Chinachoti T, Kessler P, Kirkham A, Werawatganon T. Remifentanil vs morphine for patients in intensive care unit who need short-term mechanical ventilation. J Med Assoc Thai 2002, 85(Suppl 3):S848-S857.
41. Muellejans B, Lopez A, Cross MH, Bonome C, Morrison L, Kirkham AJ. Remifentanil versus fentanyl for analgesia based sedation to provide patient comfort in the intensive care unit: a randomized, double-blind controlled trial [ISRCTN43755713]. [See comment]. Crit Care 2004, 8:R1-R11. 10.1186/cc2398, 420059, 14975049.
42. MacLaren R, Forrest LK, Kiser TH. Adjunctive dexmedetomidine therapy in the intensive care unit: a retrospective assessment of impact on sedative and analgesic requirements, levels of sedation and analgesia, and ventilatory and hemodynamic parameters. Pharmacotherapy 2007, 27:351-359. 10.1592/phco.27.3.351, 17316147.
43. Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Leguillou JL, Binhas M, Genty C, Rolland C, Bosson JL. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology 2007, 106:687-695. quiz 891-892, 10.1097/01.anes.0000264747.09017.da, 17413906.
44. Weinert CR, Calvin AD, Weinert CR, Calvin AD. Epidemiology of sedation and sedation adequacy for mechanically ventilated patients in a medical and surgical intensive care unit. [See comment]. Crit Care Med 2007, 35:393-401. 10.1097/01.CCM.0000254339.18639.1D, 17205015.
45. Chamorro C, de Latorre FJ, Montero A, Sánchez-Izquierdo JA, Jareño A, Moreno JA, Gonzalez E, Barrios M, Carpintero JL, Martín-Santos F, Otero B, Ginestal R. Comparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial. [See comment]. Crit Care Med 1996, 24:932-939. 10.1097/00003246-199606000-00010, 8681594.
46. Manley NM, Fitzpatrick RW, Long T, Jones PW. A cost analysis of alfentanil+propofol vs morphine+midazolam for the sedation of critically ill patients. Pharmacoeconomics 1997, 12:247-255. 10.2165/00019053-199712020-00015, 10170449.
47. Muellejans B, Matthey T, Scholpp J, Schill M. Sedation in the intensive care unit with remifentanil/propofol versus midazolam/fentanyl: a randomised, open-label, pharmacoeconomic trial. Crit Care 2006, 10:R91. 10.1186/cc4939, 1550941, 16780597.
48. Pandharipande PP, Pun BT, Herr DL, Maze M, Girard TD, Miller RR, Shintani AK, Thompson JL, Jackson JC, Deppen SA, Stiles RA, Dittus RS, Bernard GR, Ely EW. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. [See comment]. JAMA 2007, 298:2644-2653. 10.1001/jama.298.22.2644, 18073360.
49. Park G, Lane M, Rogers S, Bassett P. A comparison of hypnotic and analgesic based sedation in a general intensive care unit. Br J Anaesth 2007, 98:76-82. 10.1093/bja/ael320, 17158127.
50. Swart EL, van Schijndel RJ, van Loenen AC, Thijs LG. Continuous infusion of lorazepam versus medazolam in patients in the intensive care unit: sedation with lorazepam is easier to manage and is more cost-effective. Crit Care Med 1999, 27:1461-1465. 10.1097/00003246-199908000-00009, 10470750.
51. Sackey PV, Martling CR, Granath F, Radell PJ. Prolonged isoflurane sedation of intensive care unit patients with the Anesthetic Conserving Device. Crit Care Med 2004, 32:2241-2246.
52. Walsh TS, Ramsay P, Lapinlampi TP, Sarkela MO, Viertio-Oja HE, Merilainen PT. An assessment of the validity of spectral entropy as a measure of sedation state in mechanically ventilated critically ill patients. Intensive Care Med 2008, 34:308-315. 10.1007/s00134-007-0858-x, 17898996.
53. Detriche O, Berré J, Massaut J, Vincent JL. The Brussels sedation scale: use of a simple clinical sedation scale can avoid excessive sedation in patients undergoing mechanical ventilation in the intensive care unit. [See comment]. Br J Anaesth 1999, 83:698-701.
54. Costa J, Cabre L, Molina R, Carrasco G. Cost of ICU sedation: comparison of empirical and controlled sedation methods. Clin Intensive Care 1994, 5:17-21.
55. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, Francis J, Speroff T, Gautam S, Margolin R, Sessler CN, Dittus RS, Bernard GR. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA 2003, 289:2983-2991. 10.1001/jama.289.22.2983, 12799407.
56. Fraser GL, Riker RR. Sedation and analgesia in the critically ill adult. Curr Opin Anaesthesiol 2007, 20:119-123. 10.1097/ACO.0b013e32808255b4, 17413394.
57. Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. [See comment]. N Engl J Med 2000, 342:1471-1477. 10.1056/NEJM200005183422002, 10816184.
58. Girard TD, Kress JP, Fuchs BD, Thomason JW, Schweickert WD, Pun BT, Taichman DB, Dunn JG, Pohlman AS, Kinniry PA, Jackson JC, Canonico AE, Light RW, Shintani AK, Thompson JL, Gordon SM, Hall JB, Dittus RS, Bernard GR, Ely EW. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. [See comment]. Lancet 2008, 371:126-134. 10.1016/S0140-6736(08)60105-1, 18191684.
59. Pandharipande PP, Frizell J, Bun BT, Maze M, Ely EW. Randomized Controlled trial comparing dexmedetomidine with lorazepam to reduce delirium in the ICU. Anesthesiology 2006, 105:A210.
60. Hall RI, Sandham D, Cardinal P, Tweeddale M, Moher D, Wang X, Anis AH. Propofol vs midazolam for ICU sedation: a Canadian multicenter randomized trial. Chest 2001, 119:1151-1159. 10.1378/chest.119.4.1151, 11296183.
61. Samuelson K, Lundberg D, Fridlund B. Stressful memories and psychological distress in adult mechanically ventilated intensive care patients - a 2-month follow-up study. Acta Anaesthesiol Scand 2007, 51:671-678. 10.1111/j.1399-6576.2007.01292.x, 17567267.
62. Samuelson K, Lundberg D, Fridlund B. Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients. Intensive Care Medicine 2006, 32:660-667. 10.1007/s00134-006-0105-x, 16520999.