Instruments for monitoring intensive care unit sedation

G Carrasco, G Carrasco

Abstract

Although many promising objective methods (measuring systems) are available, there are no truly validated instruments for monitoring intensive care unit (ICU) sedation. Auditory evoked potentials can be used only for research in patients with a deep level of sedation. Other measuring systems require further development and validation to be useful in the ICU. Continuing research will provide an objective system to improve the monitoring and controlling of this essential treatment for ICU patients. Subjective methods (scoring systems) that are based on clinical observation have proven their usefulness in guiding sedative therapy. The Glasgow Coma Score modified by Cook and Palma (GCSC) achieves good face validity and reliability, which assures its clinical utility for routine practice and research. Other scales, in particular the Ramsay Scale, can be recommended preferably for clinical use. An accurate use of available instruments can improve the sedative treatment that we deliver to our patients.

Figures

Figure 1
Figure 1
Rational scheme for adjusting doses of sedatives
Figure 2
Figure 2
Correlation between AEPs (low latency Nb) and scoring system (more than 10 points corresponds to deep sedation).
Figure 3
Figure 3
Interobserver agreement in two sedation scales with two observers.

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