Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients

Celis-Rodríguez, E.; Cortés, Jaime; Bolívar, Y.R. Cárdenas; Carrizosa, Jorge; Pinilla, D.-I.; Záccaro, L.E. Ferrer; Birchenall, C.; López, J. Caballero; Argüello, B.M.; Abrego, G. Castillo; Arellano, Guillermo Castorena; Castell, Carmelo Dueñas; Solórzano, J.M. Jáuregui; Leal, R.; Oviedo, Juan Mauricio Pardo; Arroyo, M.; Raffán-Sanabria, Fernando; Raimondi, N.; Reina, Rosa; Lima, David Rene Rodríguez; Jiménez, J.I. Silesky; Ubiergo, Sebastián Ugarte; Escobar, Leslie; Aya, D.P. Díaz; Fowler, Clara; Nates, Joel

doi:10.1016/j.medine.2019.07.002

Cited by 28 publications

(42 citation statements)

References 4 publications

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“…No guidelines or consensus statements provided a de nition of PICS/PICS-F. However, based on other 14 PICS/PICS-F related guidelines [12][13][14][15][16][17][18][19][20][21][22][23][24][25] and nine consensus statements, the rehabilitation management of patients suffering from critical respiratory and cardiovascular illnesses (including mechanically ventilated patients) and nervous system diseases, and treatment by prevention and management of PASDIS, ICUAW, early mobilization safety criteria, and provision of family-centered care were the main focuses. Regarding the techniques used, multi-disciplinary cooperation, cross-regional cooperation, and bundling appeared to become prominent characteristics in the development of guidelines and consensus statements.…”

Section: Discussionmentioning

confidence: 99%

“…The systematic search and screening process yielded no PICS-speci c guidelines; in total, 32 guidelines and consensus statements reporting related content, such as risk factors, monitoring, diagnosis, evaluation, prevention, and treatment of PICS and PICS-F were retrieved (Table.1 [12][13][14][15], nine were developed by the corresponding state [16][17][18][19][20][21][22][23][24], and one was developed by a hospital [25]. In addition, the guidelines were divided into single and bundled theme guidelines.…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…Single guidelines included the prevention, management and non-pharmacological intervention of delirium [15,16,21], ICUAW diagnosis [20], rest and sleep improvement [25], rehabilitation of critically ill patients [24], and family-centered care [14]. Bundled guidelines included sedation/analgesia [17], management of PAD [12,19,22], and prevention and management of PASDIS [13]. Of these, nine guidelines that covered sedation/analgesia, family-centered care and PAD bundling management [26][27][28][29][30][31] were updated, indicating good continuity and timeliness.…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…This study included 14 clinical practice guidelines (13 evidence-based) [12][13][14][15][16][17][18][19][20][21][22][23][24][25] and 10 translational consensus statements (6 evidence-based) [22,32,33,[35][36][37][38][39][40][41][42][43]. Based on de nitions framework of the PICS/PICS-F, the analysis revealed that only one consensus statement clearly de ned PICS/PICS-F, while the remaining documents only described one category of clinical problems normally attributed to PICS/PICS-F.…”

Section: Content Features Of the Guidelines/consensus Statementsmentioning

confidence: 99%

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Developing Strategy of Clinical Practice Guidelines for Post-intensive Care Syndrome: A Systematic Review of 14 Practice Guidelines and 10 Consensus Statements

Wang

Zhang

et al. 2020

Preprint

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BackgroundPost-intensive care syndrome (PICS) seriously affects the quality of life of patients and their caregivers. This study systematically evaluates PICS related guidelines and consensuses to provide methodological and strategic guidance for the development and improvement of these guidelines and consensus.MethodsAn Internet search of PICS specific or related guidelines and consensus statements was conducted among academic databases and the websites. The AGREE II was used to evaluate their methodological quality. The themes and contents were evaluated based on the definition of PICS and the “patient-clinical problem-intervention-target” framework.ResultsWe included fourteen guidelines and 10 expert consensuses. The mean AGREE II score for scope and purpose was 86.89% ± 16.12%/ 79.47% ± 11.80%, 55.86% ± 29.17%/16.72% ± 16.39% for stakeholder involvement, 76.35% ± 15.82% /36.09% ±26.05% for rigor of development, 88.03% ± 15.55%/58.84% ± 28.94% for clarity of presentation, 61.79% ± 23.16/32.95% ± 20.91% for applicability, and 66.67% ± 37.96% /28.79% ± 36.54% for editorial independence in Guidelines/Consensus. Most only described a single or series of clinical related issues of PICS; only applicable for critically ill patients with clinical problems of ICUAW, pain, sleep disruption, agitation, and delirium. The interventions included risk assessment, monitoring/diagnosis, prevention, treatment, safety criteria, and home care of one or more symptoms of PICS.ConclusionsOur results suggested that development and improvement of guidelines/consensus should focus on refining the methodology, strengthening quality control, and improving presentation clarity, editorial independence, and applicability. The results may provide new idea for a future guidelines and consensus statements.

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Section: Discussionmentioning

confidence: 99%

Section: Basic Characteristicsmentioning

confidence: 99%

Section: Basic Characteristicsmentioning

confidence: 99%

Section: Content Features Of the Guidelines/consensus Statementsmentioning

confidence: 99%

See 2 more Smart Citations

Developing Strategy of Clinical Practice Guidelines for Post-intensive Care Syndrome: A Systematic Review of 14 Practice Guidelines and 10 Consensus Statements

Wang

Zhang

et al. 2020

Preprint

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“…The most recent evidence based guidelines and consensus statements recommend the prioritization of a multicomponent non-drug approach to the management of delirium,18192021 with a focus on prevention and early recognition. Embedded within recent evidence based clinical practice guidelines are recommendations to implement care bundles that include use of a validated instrument for daily assessment of all ICU patients for delirium 20222324.…”

Section: Introductionmentioning

confidence: 99%

Delirium and long term cognition in critically ill patients

Wilcox

Girard

Hough

2021

BMJ

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Delirium, a form of acute brain dysfunction, is very common in the critically ill adult patient population. Although its pathophysiology is poorly understood, multiple factors associated with delirium have been identified, many of which are coincident with critical illness. To date, no drug or non-drug treatments have been shown to improve outcomes in patients with delirium. Clinical trials have provided a limited understanding of the contributions of multiple triggers and processes of intensive care unit (ICU) acquired delirium, making identification of therapies difficult. Delirium is independently associated with poor long term outcomes, including persistent cognitive impairment. A longer duration of delirium is associated with worse long term cognition after adjustment for age, education, pre-existing cognitive function, severity of illness, and exposure to sedatives. Interestingly, differences in prevalence are seen between ICU survivor populations, with survivors of acute respiratory distress syndrome experiencing higher rates of cognitive impairment at early follow-up compared with mixed ICU survivor populations. Although cognitive performance improves over time for some ICU survivors, impairment is persistent in others. Studies have so far been unable to identify patients at higher risk of long term cognitive impairment; this is an active area of scientific investigation.

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Sedation in the Intensive Care Unit

Page

McKenzie

2021

Curr Anesthesiol Rep

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Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients

Cited by 28 publications

References 4 publications

Developing Strategy of Clinical Practice Guidelines for Post-intensive Care Syndrome: A Systematic Review of 14 Practice Guidelines and 10 Consensus Statements

Developing Strategy of Clinical Practice Guidelines for Post-intensive Care Syndrome: A Systematic Review of 14 Practice Guidelines and 10 Consensus Statements

Delirium and long term cognition in critically ill patients

Sedation in the Intensive Care Unit

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