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Curr Opin Crit Care · Aug 2008
ReviewThe pharmacology of oversedation in mechanically ventilated adults.
- John W Devlin.
- Northeastern University School of Pharmacy, Boston, Massachusetts 02115, USA. j.devlin@neu.edu
- Curr Opin Crit Care. 2008 Aug 1;14(4):403-7.
Purpose Of ReviewTo review pharmacological-related factors that affect the incidence of oversedation in mechanically ventilated adults.Recent FindingsRecent epidemiologic studies have identified a high frequency of oversedation in the ICU that is attributable, in part, to a number of pharmacokinetic, pharmacogenetic, and pharmacodynamic factors. New evidence suggests that the administration of benzodiazepines, even when dosed intermittently, will lead to more oversedation than either propofol or dexmedetomidine and is associated with greater healthcare costs. Based on this data, clinicians should limit the use of benzodiazepines to those patients with anxiety, seizures, alcohol withdrawal, or in whom a deeper level of sedation or therapeutic paralysis is required.SummaryRecognition of these new advances will help liberate patients from mechanical ventilation sooner, without compromising patient comfort.
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