‘Cooperative Sedation’: Optimizing Comfort while Maximizing Systemic and Neurological Function

Goodwin, Haley; Lewin, John J.; Mirski, Marek A.

doi:10.1007/978-3-642-25716-2_70

Cited by 4 publications

(6 citation statements)

References 47 publications

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“…We assume that better nurse-patient ratios enable lighter sedation and less use of physical restraints, as studies have suggested that inappropriate sedation is associated with insufficient staffing (Arnold et al, 2010). Daily awakening, which was introduced as a means to accelerate ventilator weaning (Kress et al, 2000), might be easier to implement in units with lighter sedation, newer drugs and better staffing (Goodwin et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

Egerod

Albarran

Ring

et al. 2013

Nursing in Critical Care

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Section: Discussionmentioning

confidence: 99%

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

Egerod

Albarran

Ring

et al. 2013

Nursing in Critical Care

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“…Current trends in ICU care, however, have shifted towards sedation strategies that provide the minimally effective amount of sedation to improve patient autonomy and preserve both the neurological exam and neurocognitive function [ 31 , 32 ]. Regardless of the etiology of neurocognitive deficits, strategies that target a lighter, more “cooperative” depth of sedation would allow the primary team to identify changes in mental status and cognition in the early phase of critical illness, when the condition may still be reversible.…”

Section: “Cooperative Sedation” and The Role Of The Nursementioning

confidence: 99%

Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview

et al. 2020

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It has become a standard measure in recent years to utilise evidence-based practice, which is associated with a greater need to implement and use advanced, reliable methods of summarising the achievements of various scientific disciplines, including such highly specialised approaches as personalised medicine. The aim of this paper was to discuss the current state of knowledge related to improvements in “nursing” involving management of delirium in intensive care units during the SARS-CoV-2 pandemic. This narrative review summarises the current knowledge concerning the challenges associated with assessment of delirium in patients with COVID-19 by ICU nurses, and the role and tasks in the personalised approach to patients with COVID-19.

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“…The overall goals of sedation in the critical care setting are to provide physiological stability, ventilator synchrony, and comfort for the patient. 1,4,7,8 Sedative agents should facilitate patients' comfort without inducing prolonged and/or deep sedation, which has been linked to prolonged mechanical ventilation and long stays in the ICU. 1,9 Identifying the appropriate level of sedation enables clinicians to adjust sedative dosing to the desired clinical effect while minimizing the risk of excessive or inadequate sedation.…”

mentioning

confidence: 99%

Stimulation of Critically Ill Patients: Relationship to Sedation

Grap

Munro

Wetzel

et al. 2016

American Journal of Critical Care

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Objectives To describe the number and type of stimulation events and the relationship of stimulation to sedation level in patients receiving mechanical ventilation. Methods A 4-hour direct observation was conducted in 103 patients receiving mechanical ventilation. Stimulation events and sedation level before and after the stimulation were documented. Eight categories of stimulation events were developed in a previous pilot study of 36 patients receiving mechanical ventilation. Sedation was measured continuously by using a processed electroencephalographic score (patient state index [PSI]) and intermittently by using the Richmond AgitationSedation Scale. Results Patients were mostly alert/mildly sedated (54.4%) at study enrollment. During the 349 hours of observation, 58.8% of the time included stimulation events. General auditory types of stimulation were most common (41.2% of observed time), followed by respiratory management and tactile family stimulation. For all events, auditorytalking, tactile-general, tactile-noxious, and tactile-highly noxious stimuli were associated with higher PSIs (all P < .001) after stimulation; other stimuli were not. Level of consciousness influenced response to stimuli, with almost all types of stimuli increasing PSI for patients more deeply sedated (PSI < 60) just before the stimuli. However, the effect of stimulation on PSI for more alert patients (PSI > 60) was small and variable. Discussion Critically ill patients receiving mechanical ventilation are subjected to various forms of auditory and tactile stimulation frequently throughout the day. All types of stimuli increased arousal in patients who were more deeply sedated. The effect of stimulation in patients who were not deeply sedated was minimal and inconsistent.

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‘Cooperative Sedation’: Optimizing Comfort while Maximizing Systemic and Neurological Function

Cited by 4 publications

References 47 publications

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

Sedation practice in Nordic and non‐Nordic ICUs: a European survey

Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview

Stimulation of Critically Ill Patients: Relationship to Sedation

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