Guía de práctica clínica basada en la evidencia para el manejo de la sedo-analgesia en el paciente adulto críticamente enfermo

Abstract

Introduction: Optimal management of sedation, analgesia and delirium offers comfort and security for the critical care patient, allows support measures to be applied more easily and enables an integral approach of medical care, at the same time that lowers the incidence of complications, wich translates in better patient outcomes.

Versión en español del método para la evaluación de la confusión en cuidados intensivos, estudio piloto de validación

“…Este cuadro tiene una prevalencia que puede alcanzar hasta el 80% en algunos grupos de pacientes ingresados y seguidos en una unidad de cuidados intensivos (UCI) 6,7 debido a factores tales como las enfermedades multisist emicas, comorbilidades y el uso de medicaciones psicoactivas 7,8 . En el marco de la UCI muchos casos no son diagnosticados debido a la falta de instrumentos validados para esto, aunque sí existe una mayor concienciación de la importancia de reconocer este cuadro ya que el retraso en su identificación puede conllevar un incremento en la morbimortalidad y, por supuesto, de la estancia hospitalaria del paciente [6][7][8][9][10] .…”

Comparison of clinical practice guidelines for the management of pain, agitation, and delirium in critically ill adult patients

“…Twenty‐one specialists (likely all physicians) in critical care medicine from nine countries (Spain, USA, Mexico, Colombia, Venezuela, Brazil, Peru, Chile, and Argentina) were selected by the Society of Critical Care Medicine of each country. The specialists used the 2007 Spanish guidelines as a starting point, because 18 of the members had already contributed to the development of these guidelines 7. A search of works published from January 2007 to July 2012 identified more than 1,000 references and was selected by the project coordinator and a methodologist.…”

Paradoxical reaction to midazolam reversed with flumazenil

“…Most cases are idiosyncratic; however, some evidence suggests that these reactions may occur secondary to a genetic link, history of alcohol abuse, or psychological disturbances. [45] Midazolam is used usually by us as recommended by the clinical practice guideline based on the evidence for the management of sedoanalgesia in the critically ill adult patient[6] (Recommendation 1B).…”

“…Moreover, saying that since the sedoanalgesia is an integral part of the management of critical patients in intensive care units and emergency services, is essential to know the clinical guidelines for evidence-based management of these drugs. [6]…”