Balancing sedation and ICU delirium management for better patient outcomes

Abstract

A growing body of evidence suggests that patients treated in intensive care units (ICUs) are not only at risk of suffering from the severity of their underlying condition, but also from harmful and potentially iatrogenic problems, namely intensive care delirium and weakness [1]. This may be associated with an unfavourable long-term prognosis leading to physical, functional, cognitive and emotional breakdown after discharge from the ICU, as well as increased mortality and morbidity [2, 3]. The majority of critically ill patients are at risk of leaving the ICU incapable of independ-ent living and become a burden to their families and society. Therefore, the aim for an intensivist should be to provide critically ill patients with the maximum level of humane care and the minimum number of necessary interventions [4, 5]. In practice, this means adequate pain control, goal-directed sedation, assessment and adequate treatment of delirium, early mobility and the proper amount of overnight sleep [6]. In this issue of AIT, the findings of an observational cohort study, an im-portant evidence regarding assessment-guided sedation practices. In study, performed a group of 714 ventilated ICU patients, the investigators compared the outcome of two patient populations from before patients) and after patients) a the