These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to sedation.
Questions addressed in this presentation include:
- In critically ill intubated adults, is there a difference between daily sedation interruption (DSI) protocols and nurse-protocolized targeted sedation in the ability to achieve and maintain a light level of sedation?
- Should propofol, as compared to a benzodiazepine, be used for sedation in mechanically ventilated adults after cardiac surgery?
- For sedation in critically ill mechanically ventilated adults:
- Should propofol, as compared to a benzodiazepine, be used?
- Should dexmedetomidine, as compared to a benzodiazepine, be used?
- Should dexmedetomidine, as compared to propofol, be used?
- Are objective sedation monitoring tools (EEG-based tools or tools such as heart rate variability, actigraphy, and evoked potentials) useful in managing sedation in critically ill intubated adults?
- What are the prevalence rates, rationale, and outcomes (harm and benefit) associated with physical restraint use in intubated or nonintubated critically ill adults?