14 June 2009

Management of Sedation and Delirium in Ventilated ICU Patients

Management of Sedation and Delirium in Ventilated ICU Patients
By:Gabriel Tsao
Stanford University, School of Medicine

Introduction
Presentation Outline
* Sedation in the ICU
o Drug overview
o Sedation assessment
o Drug selection
* Delirium in the ICU
o Incidence and mortality
o Delirium assessment
o Management of delirium

Sedation in Ventilated Patients
* Mechanical ventilation is uncomfortable and anxiety provoking
* Sedation is often necessary for comfort and airway, line, foley, nursing protection
* >85% of ventilated patients receive sedation

Commonly Used Sedatives
Central alpha-agonists
Dexmedetomidine
Fentanyl
Assessing Sedation
Selection of sedative agent
Sedation Use Recommendations
Sedation Interruption
Sedative Dependence
Presentation Outline
* Sedation in the ICU
o Drug overview
o Sedation assessment
o Drug selection
* Delirium in the ICU
o Incidence and mortality
o Delirium assessment
o Management of delirium
Delirium highly prevalent in ICU
Delirium in ventilated patients
Overview of Delirium
Subtypes of Delirium
Assessing Delirium
Pathophysiology Poorly Understood
Treatment of Hyperactive and Mixed Delirium
Other Treatments for Hyperactive/Mixed Delirium
Treatment of Hypoactive Delirium

Management of Sedation and Delirium in Ventilated ICU Patients.ppt

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