tailieunhanh - Báo cáo y học: "Optimum sedation and analgesia in critical illness: we need to keep trying"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Optimum sedation and analgesia in critical illness: we need to keep trying. | Available online http content 8 6 433 Commentary Optimum sedation and analgesia in critical illness we need to keep trying Gavin G Lavery Director of Critical Care Services Regional Intensive Care Unit Royal Hospitals Trust Belfast UK Corresponding author Gavin G Lavery Published online 3 November 2004 This article is online at http content 8 6 433 2004 BioMed Central Ltd Related to Research by van de Leur et al. see page 513 Critical Care 2004 8 433-434 DOI cc2998 Abstract Many studies have documented patients distressing recollections of the intensive care unit ICU . The study by van de Leur and colleagues conducted in a group of surgical ICU patients with moderate severity of sickness found that the frequency of such unpleasant memories was increased in those able to recall factual information about their stay in the ICU. The study did not include sedation scoring but it did use a simple tool to assess factual recall. This tool appeared reliable and could be easily applied in any ICU. Previous work strongly suggests that abolishing memory of ICU by using deep sedation would not be an appropriate response to these findings. Rather we need to work on strategies that reduce distress by improving analgesia reducing noxious stimuli if possible and potentially using pharmacology to produce a calm patient with minimal sedation. Achieving the latter is rarely possible today but it might become possible with future drug development. Keywords amnesia critical care hallucinations recollection sedation In a study reported in this issue of Critical Care van de Leur and colleagues 1 investigated the experience of critical illness and intensive care unit ICU support from the patient s perspective. Although many workers have documented memories of a period spent in the ICU van de Leur and coworkers attempted to relate memories of discomfort in ICU to patients factual recall of the ICU. Memories of the ICU .