Interrupción diaria de la sedación; ¿siempre es un indicador de calidad?

doi:10.1016/j.medin.2011.11.015

Medicina Intensiva

Volume 36, Issue 4, May 2012, Pages 288-293

https://doi.org/10.1016/j.medin.2011.11.015 Get rights and content

Resumen

La SEMICYUC ha publicado recientemente una nueva revisión de los Indicadores de Calidad en el Enfermo Crítico, entre los cuales se cita la Interrupción diaria de la Sedación. Dada la controversia que esta práctica conlleva, se revisan los estudios realizados y se proponen unas recomendaciones para su implementación.

Abstract

The Spanish Society of Critical Care Medicine (SEMICYUC) has recently published an updated version of Quality Indicators in Critical Care. Daily sedative interruption is included among them. As this practice is controversial, research studies are revised and guidelines for its implementation are proposed.

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Miembro del Advisory Board de Laboratorios Orion-Pharma SL.

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Cited by (2)

Do sedation and analgesia contribute to long-term cognitive dysfunction in critical care survivors?
2018, Medicina Intensiva
Citation Excerpt :
However, patients in the intervention group had a lower Impact of Event Score (p = 0.02), suggesting that the daily sedation interruption strategy was beneficial rather than harmful and reduced symptoms of post-traumatic stress disorder. Since that study, several trials have explored the effect of daily sedation interruption on clinical outcomes in ICU patients.18 Daily spontaneous awakening trials seem to reduce time in coma, ICU and hospital length of stay, sedation and to increase time off MV, and the 1-year survival rates.19,20
Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation. Over the last decade a vast body of literature has been generated regarding different sedation strategies, with the aim of reducing the levels of sedation in critically ill patients. There has also been a growing interest in acute brain dysfunction, or delirium, in the ICU. However, the effect of sedation during ICU stay upon long-term cognitive deficits in ICU survivors remains unclear. Strategies for reducing sedation levels in the ICU do not seem to be associated with worse cognitive and psychological status among ICU survivors. Sedation strategy and management efforts therefore should seek to secure the best possible state in the mechanically ventilated patient and lower the prevalence of delirium, in order to prevent long-term cognitive alterations.
La sedación profunda durante la estancia en una Unidad de Cuidados Intensivos (UCI) puede afectar negativamente al estado clínico y cognitivo de los pacientes críticos sometidos a ventilación mecánica. En la última década ha aparecido gran cantidad de literatura sobre diferentes estrategias dirigidas a reducir los niveles de sedación en el paciente crítico. Además, ha aumentado el interés sobre la disfunción cerebral aguda o delirium. Sin embargo, el efecto de la sedación sobre los déficits cognitivos a largo plazo continúa siendo poco conocido. Las estrategias centradas en reducir los niveles de sedación en UCI no parecen estar asociadas con un peor estado cognitivo y psicológico de los supervivientes. Por lo tanto, las estrategias de manejo de la sedación en UCI deberían focalizarse en mejorar el estado del paciente ventilado, así como en disminuir el delirium, con el fin de prevenir las alteraciones cognitivas a largo plazo.
Clinical study of the influence of daily sedation interruption on fluctuation of blood glucose level and mortality of critical patients with multiple trauma
2014, Chinese Critical Care Medicine

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Punto de vistaInterrupción diaria de la sedación; ¿siempre es un indicador de calidad?Daily interruption of sedation: always a quality indicator?

Resumen

Abstract

Section snippets

Conflicto de intereses

J Crit Care

Lancet

Lancet

Med Intensiva

Crit Care Clin

Crit Care Clin

Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation

N Engl J Med

N Engl J Med

Daily interruption of sedative infusions in critically ill patients

N Engl J Med

Daily interruption of sedative infusions in critically ill patients

N Engl J Med

The long-term psychological effects of daily sedative interruption on critically ill patients

Am J Respir Crit Care Med

Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients

Crit Care Med

Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease

Crit Care Med

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

Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial

J Adv Nurs

Punto de vista
Interrupción diaria de la sedación; ¿siempre es un indicador de calidad?Daily interruption of sedation: always a quality indicator?