Review
Year 2017,
Volume: 21 Issue: 2, 50 - 54, 30.12.2017
Abstract
Sedation is the
suppression of the central nervous system by using sedative drugs. Sedation is
widely used in intensive care units to reduce patient anxiety, agitation and
pain, support patient-ventilator compliance, maintain hemodynamic stability, reduce
intracranial pressure, facilitate patient care during aspiration, invasive
procedures and dressings. Optimal sedation should be a target for all patients
followed up in intensive care unit. Excessive or insufficient sedation leads to
many complications and delay of recovery. It is important to evaluate the
sedation level of patients with a continuous and effective method and to give
the sedation within a protocol in order to prevent complications. Different
sedation strategies are used in intensive care units. Nurse-implemented sedation protocol is one of these strategies. It is stated
that when the nurse-implemented sedation protocols are used, the sedation and
pain control is better provided and the sedative and analgesic doses applied
are decreased. In this article, the application of sedation in intensive care
units, the use of protocol in patients' follow-up and their results in terms of
patients are evaluated and the importance of nursing-implemented sedation
protocols is discussed.
References
- Referans1-Tüzüner F. Yoğun bakımda sedasyon, analjezi ve deliryum. Anestezi-Yoğun Bakım-Ağrı. 1. ed. Ankara; 2010;1221-4. Referans2-Öztürk M, Ay S. Bilinçli Sedasyon. Cumhuriyet Üniversitesi Diş hekimliği Fakültesi Dergisi 2000;3:2. Referans3-Chlan LL, Engeland WC, Anthony A. Influence of Music on the Stres Response in Patients Receiving Mechanical Ventilatory Support: A Pilot Study, American Journal of Critical Care 2007;16(2):141-145. Referans4-Burry L, Rose L, McCullagh IJ, Fergusson DA., Ferguson ND, Mehta S. Daily sedation interruption versus no daily sedation interruption for critically ill adult patients requiring invasive mechanical ventilation. Cochrane Database of Systematic Reviews, 2014; Issue 7. Referans5-Grap MJ, Munro CL, Wetzel PA, Best AM, Ketchum JM, Hamilton VA, Arief NY, Pickler R, Sessler CN. Sedatıon ın Adults Receıvıng Mechanical Ventılatıon: Physiological and Comfort Outcomes. American Journal Of Critical Care 2012; May, Volume 21, No.3. Referans6-Akıncı SB, Kanbak M, Güler A, Canbay M, Aypar Ü. Mekanik ventilasyondaki hastalarda stres yaratan deneyimler. Türk Anest Rean Der Dergisi 2007;35(5): 320-328. Referans7-Samuelson K, Lundberg D, Fridlund B. Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients. J Intensive Care Med 2006;32: 660-667. Referans8-Wunsch H, Kress JP. A new era for sedation in ICU patients. JAMA 2009;301:542-544. Referans9- Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002;30:119-41. Referans10- Martin J, Franck M, Fischer M, Spies C. Sedation and analgesia in ferman intensive care units: How is it done in reality? Results of a patient-based survey of analgesia and sedation. Intensive Care Med 2006;32:1137-1142. Referans11-Li S , Wang D, Yang B. The progress of light sedation for critically ill adult patients in intensive care unit. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2016 .28(1):89-93. Referans12-Salluh JI, Soares M, Teles JM. Delirium epidemiology in critical care: an international study. Crit Care 2010;14:R210. Referans13-Rhoney DH, Murry KR. National survey of the use of sedating drugs, neuromuscular blocking agents, and reversal agents in the intensive care unit. J Intensive Care Med 2003;18:139-145. Referans14-Guttormson JL, Chlan L, Weinert C, Savik K. Factors infl uencing nurse sedation practices with mechanically ventilated patients. Intensive and Critical Care Nursing 2010;26:44-50. Referans15-Nseir S, Makris D, Mathieu D, Durocher A, Marquette CH. Intensive care unit-acquired infection as a side effect of sedation. Crit Care 2010;14:R30. Referans16-Seyhan TÖ. Yoğun bakımda kullanılan sedatif ve analjezik ajanlar. Yoğun Bakım Derneği Dergisi 2006;4(1):45-49. Referans17-Kress JP, Vinayak AG, Levitt J, Schweickert WD, Gehlbach BK, Zimmerman F. Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease. Crit Care Med 2007;35:365-71. Referans18-Hogarth DK, Hall J. Management of sedation in mechanically ventilated patients. Curr Opin Crit Care 2004;10:40-6. Referans19-Mehta S. Canadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients. Crit Care Med 2006;34:374-380. Referans20-Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342:1471–1477. Referans21-Shahab M, Yousefi H, Yazdannik AR. The effect of daily sedation interruption protocol on early incidence of ventilator-associated pneumonia among patients hospitalized in critical care units receiving mechanical ventilation. Iran J Nurs Midwifery Res 2016; 21(5): 541–546. Referans22-Kress JP, Pohlman AS, Hall JB. Sedation and analgesia in the intensive care unit. Am J Respir Crit Care Med 2002;166:1024-8. Referans23-Hansen L, Lange R, and Gupta S. Development and Evaluation of a Guideline for Monitoring Propylene Glycol Toxicity in Pediatric Intensive Care Unit Patients Receiving Continuous Infusion Lorazepam. Pediatr Pharmacol Ther 2015;20(5):367–372. Referans24-Tobias JD. Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit. Crit Care Med 2000;28:2122–2132. Referans25- Egerod I. Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients. J Clin Nurs 2002;11:831-840. Referans26-Girard TD, Kress JP, Fuchs BD. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): A randomised controlled trial. Lancet 2008;371:126–134. Referans27-Treggiari MM, Romand JA, Yanez ND. Randomized trial of light versus deep sedation on mental health after critical illness. Crit Care Med 2009; 37:2527–2534. Referans28-Quenot JP, Ladoire S, Devoucoux F. Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia. Crit Care Med 2007;35:2031–2036. Referans29-Elliott R, McKinley S, Aitken LM. The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit. Intensive Care Med 2006;32:1506–1514 Referans30-Mehta S, Burry L, Martinez-Motta JC. Canadian Critical Care Trials Group: A randomized trial of daily awakening in critically ill patients managed with a sedation protocol: A pilot trial. Crit Care Med 2008;36:2092–2099. Referans31-Brattebø G, Hofoss D, Flaatten H. Effect of a scoring system and protocol for sedation on duration of patients’ need for ventilator support in a surgical intensive care unit. BMJ 2002;324:1386–1389 Referans32-Payen JF, Bosson JL, Chanques G. DOLOREA Investigators: Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: A post Hoc analysis of the DOLOREA study. Anesthesiology, 2009;111:1308–1316. Referans33-Robinson BR, Mueller EW, Henson K. An analgesia-deliriumsedation protocol for critically ill trauma patients reduces ventilator days and hospital length of stay. J Trauma 2008;65:517–526. Referans34-Sessler CN, Pedram, S. Protocolized and target-based sedation and analgesia in the ICU. Crit Care Clin 2009;25:489–513. Referans35-Tanios MA, Wit M, Epstein SK. Perceived barriers to the use of sedation protocols and daily sedation interruption: A multidisciplinary survey. J Crit Care 2009;24:66–73. Referans36.Payen JF, Chanques G, Mantz J. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patient-based study. Anesthesiology 2007;106:687–695. Referans37-Martin J, Franck M, Fischer M. Sedation and analgesia in German intensive care units: How is it done in reality? Results of a patientbased survey of analgesia and sedation. Intensive Care Med 2006;32:1137–1142. Referans38-Grap MJ, Munro CL, Wetzel PA, Best AM, Ketchum JM, Hamilton VA, Arief NY, Pickler R, Sessler CN. American Journal Of Critical Care 2012; May, Volume 21, No.3. Referans39-Abdar ME, Rafiei H, Abbaszade A, Hosseinrezaei H, Abdar ZE, Delaram M, Ahmadineja, M. Effects of nurses’ practice of a sedation protocol on sedation and consciousness levels of patients on mechanical ventilation. Iran J Nurs Midwifery Res 2013;18:391–395. Referans40- Brattebø G, Hofoss D, Flaatten H, Muri AK, Gjerde S, Plsek PE. Effect of a scoring system and protocol for sedation on duration of patients’ need for ventilator support in a surgical intensive care unit. Qual Saf Health Care 2004;13:203-5. Referans41-Walder B, Tramer MR. Analgesia and sedation in critically ill patients. Swiss Med Wkly 2004;134:333-46. Referans42-Wit M, Gennings C, Jenvey WI, Epstein SK. Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Critical Care 2008;12:R70. Referans43-Brook AD, Ahrens TS, Schaiff R, Prentice D, Sherman G, Shannon W. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999;27:2609-15. Referans44-Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous iv sedation is associated with prolongation of mechanical ventilation. Chest, 1998;114:541-548. Referans45-Shehabi Y, Bellomo R, Mehta S, Riker R, Takala J. Intensive care sedation: the past, present and the future. Critical Care 2013;17:322
Year 2017,
Volume: 21 Issue: 2, 50 - 54, 30.12.2017
Abstract
Sedasyon; sedatif etkili ilaçlar kullanılarak santral sinir sisteminin baskılanmasıdır. Sedasyon, yoğun bakım ünitelerinde, hastaların anksiyete, ajitasyon ve ağrısını azaltmak, hasta-ventilatör uyumunu desteklemek, hemodinamik stabiliteyi sürdürmek, intrakranial basıncı azaltmak aspirasyon, invaziv girişimler ve pansuman gibi işlemler sırasında hastanın bakımını kolaylaştırmak amacıyla yaygın olarak kullanılmaktadır. Optimal sedasyon, yoğun bakım ünitesinde takip edilen tüm hastalar için bir hedef olmalıdır. Aşırı veya yetersiz sedasyon birçok komplikasyonun oluşmasına ve iyileşmenin gecikmesine neden olmaktadır. Hastaların sedasyon düzeyinin sürekli ve etkili bir yöntemle değerlendirilmesi ve sedasyonun bir protokol dahilinde verilmesi komplikasyonların önlenmesi açısından önemlidir. Yoğun bakım ünitelerinde farklı sedasyon stratejileri kullanılmaktadır. Hemşire kontrollü sedasyon protokolü bu stratejilerden biridir. Hemşire kontrollü sedasyon protokollerinin kullanıldığı durumlarda sedasyon ve ağrı kontrolünün daha iyi sağlandığı ve uygulanan sedatif ve analjezik dozlarının azaldığı belirtilmektedir. Bu makalede, yoğun bakım ünitelerinde sedasyon uygulama şekilleri, hasta takibinde protokol kullanımı ve bunların hasta açısından sonuçları değerlendirilerek, hemşire kontrollü sedasyon protokollerinin uygulamadaki önemi ele alınmıştır.
Keywords
References
- Referans1-Tüzüner F. Yoğun bakımda sedasyon, analjezi ve deliryum. Anestezi-Yoğun Bakım-Ağrı. 1. ed. Ankara; 2010;1221-4. Referans2-Öztürk M, Ay S. Bilinçli Sedasyon. Cumhuriyet Üniversitesi Diş hekimliği Fakültesi Dergisi 2000;3:2. Referans3-Chlan LL, Engeland WC, Anthony A. Influence of Music on the Stres Response in Patients Receiving Mechanical Ventilatory Support: A Pilot Study, American Journal of Critical Care 2007;16(2):141-145. Referans4-Burry L, Rose L, McCullagh IJ, Fergusson DA., Ferguson ND, Mehta S. Daily sedation interruption versus no daily sedation interruption for critically ill adult patients requiring invasive mechanical ventilation. Cochrane Database of Systematic Reviews, 2014; Issue 7. Referans5-Grap MJ, Munro CL, Wetzel PA, Best AM, Ketchum JM, Hamilton VA, Arief NY, Pickler R, Sessler CN. Sedatıon ın Adults Receıvıng Mechanical Ventılatıon: Physiological and Comfort Outcomes. American Journal Of Critical Care 2012; May, Volume 21, No.3. Referans6-Akıncı SB, Kanbak M, Güler A, Canbay M, Aypar Ü. Mekanik ventilasyondaki hastalarda stres yaratan deneyimler. Türk Anest Rean Der Dergisi 2007;35(5): 320-328. Referans7-Samuelson K, Lundberg D, Fridlund B. Memory in relation to depth of sedation in adult mechanically ventilated intensive care patients. J Intensive Care Med 2006;32: 660-667. Referans8-Wunsch H, Kress JP. A new era for sedation in ICU patients. JAMA 2009;301:542-544. Referans9- Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002;30:119-41. Referans10- Martin J, Franck M, Fischer M, Spies C. Sedation and analgesia in ferman intensive care units: How is it done in reality? Results of a patient-based survey of analgesia and sedation. Intensive Care Med 2006;32:1137-1142. Referans11-Li S , Wang D, Yang B. The progress of light sedation for critically ill adult patients in intensive care unit. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2016 .28(1):89-93. Referans12-Salluh JI, Soares M, Teles JM. Delirium epidemiology in critical care: an international study. Crit Care 2010;14:R210. Referans13-Rhoney DH, Murry KR. National survey of the use of sedating drugs, neuromuscular blocking agents, and reversal agents in the intensive care unit. J Intensive Care Med 2003;18:139-145. Referans14-Guttormson JL, Chlan L, Weinert C, Savik K. Factors infl uencing nurse sedation practices with mechanically ventilated patients. Intensive and Critical Care Nursing 2010;26:44-50. Referans15-Nseir S, Makris D, Mathieu D, Durocher A, Marquette CH. Intensive care unit-acquired infection as a side effect of sedation. Crit Care 2010;14:R30. Referans16-Seyhan TÖ. Yoğun bakımda kullanılan sedatif ve analjezik ajanlar. Yoğun Bakım Derneği Dergisi 2006;4(1):45-49. Referans17-Kress JP, Vinayak AG, Levitt J, Schweickert WD, Gehlbach BK, Zimmerman F. Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease. Crit Care Med 2007;35:365-71. Referans18-Hogarth DK, Hall J. Management of sedation in mechanically ventilated patients. Curr Opin Crit Care 2004;10:40-6. Referans19-Mehta S. Canadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients. Crit Care Med 2006;34:374-380. Referans20-Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342:1471–1477. Referans21-Shahab M, Yousefi H, Yazdannik AR. The effect of daily sedation interruption protocol on early incidence of ventilator-associated pneumonia among patients hospitalized in critical care units receiving mechanical ventilation. Iran J Nurs Midwifery Res 2016; 21(5): 541–546. Referans22-Kress JP, Pohlman AS, Hall JB. Sedation and analgesia in the intensive care unit. Am J Respir Crit Care Med 2002;166:1024-8. Referans23-Hansen L, Lange R, and Gupta S. Development and Evaluation of a Guideline for Monitoring Propylene Glycol Toxicity in Pediatric Intensive Care Unit Patients Receiving Continuous Infusion Lorazepam. Pediatr Pharmacol Ther 2015;20(5):367–372. Referans24-Tobias JD. Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit. Crit Care Med 2000;28:2122–2132. Referans25- Egerod I. Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients. J Clin Nurs 2002;11:831-840. Referans26-Girard TD, Kress JP, Fuchs BD. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): A randomised controlled trial. Lancet 2008;371:126–134. Referans27-Treggiari MM, Romand JA, Yanez ND. Randomized trial of light versus deep sedation on mental health after critical illness. Crit Care Med 2009; 37:2527–2534. Referans28-Quenot JP, Ladoire S, Devoucoux F. Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia. Crit Care Med 2007;35:2031–2036. Referans29-Elliott R, McKinley S, Aitken LM. The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit. Intensive Care Med 2006;32:1506–1514 Referans30-Mehta S, Burry L, Martinez-Motta JC. Canadian Critical Care Trials Group: A randomized trial of daily awakening in critically ill patients managed with a sedation protocol: A pilot trial. Crit Care Med 2008;36:2092–2099. Referans31-Brattebø G, Hofoss D, Flaatten H. Effect of a scoring system and protocol for sedation on duration of patients’ need for ventilator support in a surgical intensive care unit. BMJ 2002;324:1386–1389 Referans32-Payen JF, Bosson JL, Chanques G. DOLOREA Investigators: Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: A post Hoc analysis of the DOLOREA study. Anesthesiology, 2009;111:1308–1316. Referans33-Robinson BR, Mueller EW, Henson K. An analgesia-deliriumsedation protocol for critically ill trauma patients reduces ventilator days and hospital length of stay. J Trauma 2008;65:517–526. Referans34-Sessler CN, Pedram, S. Protocolized and target-based sedation and analgesia in the ICU. Crit Care Clin 2009;25:489–513. Referans35-Tanios MA, Wit M, Epstein SK. Perceived barriers to the use of sedation protocols and daily sedation interruption: A multidisciplinary survey. J Crit Care 2009;24:66–73. Referans36.Payen JF, Chanques G, Mantz J. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patient-based study. Anesthesiology 2007;106:687–695. Referans37-Martin J, Franck M, Fischer M. Sedation and analgesia in German intensive care units: How is it done in reality? Results of a patientbased survey of analgesia and sedation. Intensive Care Med 2006;32:1137–1142. Referans38-Grap MJ, Munro CL, Wetzel PA, Best AM, Ketchum JM, Hamilton VA, Arief NY, Pickler R, Sessler CN. American Journal Of Critical Care 2012; May, Volume 21, No.3. Referans39-Abdar ME, Rafiei H, Abbaszade A, Hosseinrezaei H, Abdar ZE, Delaram M, Ahmadineja, M. Effects of nurses’ practice of a sedation protocol on sedation and consciousness levels of patients on mechanical ventilation. Iran J Nurs Midwifery Res 2013;18:391–395. Referans40- Brattebø G, Hofoss D, Flaatten H, Muri AK, Gjerde S, Plsek PE. Effect of a scoring system and protocol for sedation on duration of patients’ need for ventilator support in a surgical intensive care unit. Qual Saf Health Care 2004;13:203-5. Referans41-Walder B, Tramer MR. Analgesia and sedation in critically ill patients. Swiss Med Wkly 2004;134:333-46. Referans42-Wit M, Gennings C, Jenvey WI, Epstein SK. Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Critical Care 2008;12:R70. Referans43-Brook AD, Ahrens TS, Schaiff R, Prentice D, Sherman G, Shannon W. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999;27:2609-15. Referans44-Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous iv sedation is associated with prolongation of mechanical ventilation. Chest, 1998;114:541-548. Referans45-Shehabi Y, Bellomo R, Mehta S, Riker R, Takala J. Intensive care sedation: the past, present and the future. Critical Care 2013;17:322
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Details
| Subjects | Nursing |
|---|---|
| Journal Section | REVIEW |
| Authors | |
| Publication Date | December 30, 2017 |
| Published in Issue | Year 2017 Volume: 21 Issue: 2 |
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