TdC 227: Sedação e analgesia

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2M ago 54:49

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Kaue Malpighi convida Gabriel Paes e Amyr Chacar para falar de sedação e analgesia. Baseado em 4 casos, conversamos um pouco sobre meta de sedação, quais os principais sedativos, como fazer o despertar, quais analgésicos utilizar e muito mais.

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Referências:

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Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet. 2010;375(9713):475-480. doi:10.1016/S0140-6736(09)62072-9
Olsen HT, Nedergaard HK, Strøm T, et al. Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients. N Engl J Med. 2020;382(12):1103-1111. doi:10.1056/NEJMoa1906759
National Heart, Lung, and Blood Institute PETAL Clinical Trials Network, Moss M, Huang DT, et al. Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome. N Engl J Med. 2019;380(21):1997-2008. doi:10.1056/NEJMoa1901686
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Lewis K, Alshamsi F, Carayannopoulos KL, et al. Dexmedetomidine vs other sedatives in critically ill mechanically ventilated adults: a systematic review and meta-analysis of randomized trials. Intensive Care Med. 2022;48(7):811-840. doi:10.1007/s00134-022-06712-2
Shehabi Y, Bellomo R, Reade MC, et al. Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med. 2012;186(8):724-731. doi:10.1164/rccm.201203-0522OC
Treggiari MM, Romand JA, Yanez ND, et al. Randomized trial of light versus deep sedation on mental health after critical illness. Crit Care Med. 2009;37(9):2527-2534. doi:10.1097/CCM.0b013e3181a5689f
Hughes CG, Girard TD, Pandharipande PP. Daily sedation interruption versus targeted light sedation strategies in ICU patients [published correction appears in Crit Care Med. 2013 Nov;41(11):e400]. Crit Care Med. 2013;41(9 Suppl 1):S39-S45. doi:10.1097/CCM.0b013e3182a168c5
Wheeler KE, Grilli R, Centofanti JE, et al. Adjuvant Analgesic Use in the Critically Ill: A Systematic Review and Meta-Analysis. Crit Care Explor. 2020;2(7):e0157. Published 2020 Jul 6. doi:10.1097/CCE.0000000000000157

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