Características e impacto de la sedación, la analgesia y el bloqueo neuromuscular en los pacientes críticos que recibieron ventilación mecánica prolongada

Abstract

Sedatives were frequently employed and deep sedation was common. Midazolam and fentanyl were the most frequently administered drugs. The use of NMB might be independently associated to greater mortality.

The implementation of an analgesia-based sedation protocol reduced deep sedation and proved to be safe and feasible in patients on mechanical ventilation

“…(17) Midazolam and fentanyl were the most frequently used drugs for sedation and analgesia during mechanical ventilation. They were used in 133 (85.8%) patients and 126 (81.3%) patients, respectively.…”

“…An observational period lasted 10 weeks from April to June 2006. (17) This observational phase was followed by data analysis and a workshop in which an analgesia-based, goal-directed, nurse-driven sedation protocol was designed. After nurse and medical training for its application, the interventional phase was applied for 12 weeks from late October 2006 until January 2007.…”

“…A key finding was the high proportion of patients in deep sedation. (17) Based on this finding, an analgesia-based, goal-directed, nurse-driven sedation protocol was designed for the research team. This proposal was discussed in group sessions, and it was finally approved by all of the participants.…”

“…(12) This table was designed based on the observed doses of fentanyl and midazolam during the observational phase. (17) At any time, i.v. boluses were allowed before increasing the infusion rates of the sedatives.…”

Prácticas nacionales de analgesia, sedación y delirium en las Unidades de Cuidados Intensivos de adultos en Chile

“…El presente trabajo corresponde al primer estudio que, mediante una encuesta a profesionales de la salud que trabajan en UCI, recoge información sobre los conocimientos, percepciones y creencias respecto a las prácticas de ASBD en las UCI de adultos a nivel nacional. Previamente, integrantes de nuestro equipo, realizaron un estudio multicéntrico nacional que describió el uso de analgesia, sedación y BNM, pero fue llevado a cabo hace más de 10 años y no incluyó delirium 20 . Nuestros hallazgos documentan una heterogénea adherencia a las recomendaciones internacionales para el manejo de la ASBD en los pacientes críticos sometidos a ventilación mecánica invasiva (VMI).…”