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Sedation, Analgesia, andSedation, Analgesia, andNeuromuscular Blockade in theNeuromuscular Blockade in theAdult ICUAdult ICU
Giuditta Angelini, MDGiuditta Angelini, MD
University of WisconsinMadison, WI
Gil Fraser, PharmD, FCCMGil Fraser, PharmD, FCCM
Maine Medical Center Portland, ME
Doug Coursin, MD, FCCMDoug Coursin, MD, FCCM
University of WisconsinMadison, WI
 
 
ObjectivesObjectives
Participants should be able to:
Describe the SCCM guidelines for sedation, analgesia, and chemicalparalysisDescribe the benefits of daily awakening/lightening and sedation titrationprogramsDevise a rational pharmacologic strategy based on treatment goals andcomorbidities Participants should be able to:Describe the SCCM guidelines for sedation, analgesia, and chemicalparalysisDescribe the benefits of daily awakening/lightening and sedation titrationprogramsDevise a rational pharmacologic strategy based on treatment goals andcomorbidities
 
 
What We Know About ICUWhat We Know About ICUAgitation/DiscomfortAgitation/Discomfort
Prevalence
•50% incidence in those with length of stay > 24 hours
Primary causes: unrelieved pain, delirium, anxiety, sleepdeprivation, etc.Immediate sequelae:
•Patient-ventilator dyssynchrony•Increased oxygen consumption•Self (and health care provider) injury•Family anxiety
Long-term sequelae: chronic anxiety disorders and post-traumatic stress disorder (PTSD)
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