Time to Wake Up the Patients in the ICU: a Crazy Idea or Common Sense?

 

T. Strøm, P. Toft

 

 

Minerva Anestesiologica, 2010, 77, No 1

 

 

With the first generation of ventilation, it was often necessary to sedate patients to avoid dyssynchrony between patient and ventilator. The standard treatment of patients in need of mechanical ventilation has therefore traditionally included sedation is no longer necessary. In the last decade, support has grown for a reduction in the use of sedation. The focus has been placed on the correlation between the depth of sedation and the length of mechanical ventilation. Additionally, it has been shown that combining both a spontaneous breathing trial alone. We have recently shown in a randomized study that the use of no sedation, compared to the standard treatment with sedation and a daily wake up trial, reduced the time that patients were dependent on mechanical ventilation, the length of the patients' stay in the intensive care unit, and the total length of the hospital stay. All evidence indicates that the use of sedative drugs should be reduced, patients should be mobilized, and each patient's needs should be evaluated on a daily basis to optimize the care individual patient.

 

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Stiamo assistendo in Terapia Intensiva ad una profonda sfida culturale: pazienti svegli, parenti presenti, staff consapevole dei limiti e delle possibilità. Non è facile "cambiare testa", ma è il primo passo per stare meglio. Tutti.

Link veloci

Gestire il dolore

ico-flowchartdoloreFlowchart dolore
ico-vnrVNR
ico-bpsBPS

Gestire la sedazione

ico-flowchart-sedaz-agitFlowchart sedaz/agitaz
ico-rassRASS

Gestire il delirium

ico-flowchart-deliriumFlowchart Delirium
ico-manuale-cam-icuManuale CAM-ICU
ico-schedalavoro-cam-icuScheda di lavoro CAM-ICU
ico-icdscICDSC

 

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