Lecture Summary

The goals of ICU sedation remained the same over the years and throughout the COVID pandemic. Clinical practice guidelines and expert reviews continue to recommend analgesia first, light sedation and the use of non-benzodiazepines sedative agents. Recent RCTs on ICU sedation, although showed no superiority of one agent on mortality outcome in general, revealed a significant age related, and operative vs non-operative heterogeneity of treatment effect with dexmedetomidine on mortality. This suggests that the early use of dexmedetomidine in older (≥65 y) and in all operative patients, and propofol in younger (<65y) medical patients may reduce the risk of death, increase days free of delirium and coma, and ventilator free days. Thus, an individualized patient and symptom oriented algorithm for ICU sedation is preferred.

Target Audience

Critical Care Doctors
Experienced Critical Care Nurses

Learning Objectives:

Upon completion of this activity, you should be able to:

• Describe the practical benefits and potential side effects of commonly used sedative agents
• Review contemporary evidence and its implication for ICU sedation practice
• Understand the principles and the applications of a practical Patient and Symptom Oriented Sedation Algorithm

None.