ICU镇静深浅谈

The depth of sedation in intensive care unit

最初重症监护病房的镇静实践源于麻醉,容易导致深镇静或过度镇静。但随着研究进展,学者们逐步认识到深镇静对患者带来的危害,故提倡浅镇静。但对一些特定目标人群,如严重颅脑损伤、癫痫持续状态、治疗性低温以及严重急性呼吸窘迫综合征等患者,则必须给于较深度的镇静。对大多数重症患者实行浅镇静是有益的。为避免不必要的过度镇静,目前推荐采用镇痛性镇静、以浅镇静为靶目标的程序化镇静以及早期目标指向性镇静等策略。

The initial sedation practice in intensive care unit （ICU） which derived from anesthesia easily led to deep level or over sedation. However, with development of the research, deep sedation was gradually regarded to bring big harm to patients. So light sedation is recommended nowadays. However, the special target patients such as severe brain injury, persistent epilepsy, therapeutic low temperature and severe acute respiratory distress syndrome （ARDS） all need sedation in deep level. It is benefcial to treat most of critical ill patients with light sedation. To avoid unnecessary over sedation, strategies such as analgosedation, the protocolized sedation in goal of light level and early goal directed sedation are praised at present.