Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients
| Autor: | L. E. Ferrer Záccaro, J. Caballero López, R. Leal, G. Castillo Abrego, Joseph L. Nates, S. Ugarte Ubiergo, Y.R. Cárdenas Bolívar, N. Raimondi, J.M. Jáuregui Solórzano, Ramsés Reina, E. Celis-Rodríguez, Fernando Raffán-Sanabria, J.A. Carrizosa González, C. Birchenall, B.M. Argüello, Darío Pinilla, M. Arroyo, D.R. Rodríguez Lima, J.C. Díaz Cortés, D.P. Díaz Aya, J.M. Pardo Oviedo, C. Dueñas Castell, G. Castorena Arellano, Clara S. Fowler, J.I. Silesky Jiménez, L.G. Gómez Escobar |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Evidence-based practice Critical Care Critical Illness Midazolam Sedation Conscious Sedation MEDLINE Cochrane Library Benzodiazepines 03 medical and health sciences 0302 clinical medicine Intensive care medicine Humans Hypnotics and Sedatives Pain Management Anesthesia Dexmedetomidine Intensive care medicine Evidence-Based Medicine business.industry Delirium 030208 emergency & critical care medicine Intensive Care Units Systematic review 030228 respiratory system Analgesia medicine.symptom business medicine.drug |
| Zdroj: | Medicina Intensiva (English Edition). 44:171-184 |
| ISSN: | 2173-5727 |
| Popis: | Given the importance of the management of sedation, analgesia and delirium in Intensive Care Units, and in order to update the previously published guidelines, a new clinical practice guide is presented, addressing the most relevant management and intervention aspects based on the recent literature. A group of 24 intensivists from 9 countries of the Pan-American and Iberian Federation of Societies of Critical Medicine and Intensive Therapy met to develop the guidelines. Assessment of evidence quality and recommendations was made according to the Grading of Recommendations Assessment, Development and Evaluation Working Group. A systematic search of the literature was carried out using MEDLINE, Cochrane Library databases such as the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects, the National Health Service Economic Evaluation Database and the database of Latin American and Caribbean Literature in Health Sciences (LILACS). A total of 438 references were selected. After consensus, 47 strong recommendations with high and moderate quality evidence, 14 conditional recommendations with moderate quality evidence, and 65 conditional recommendations with low quality evidence were established. Finally, the importance of initial and multimodal pain management was underscored. Emphasis was placed on decreasing sedation levels and the use of deep sedation only in specific cases. The evidence and recommendations for the use of drugs such as dexmedetomidine, remifentanil, ketamine and others were incremented. |
| Databáze: | OpenAIRE |
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