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Rebuttal From Dr SkrobikRebuttal From Dr Skrobik

Yoanna Skrobik, MD
Author and Funding Information

From Soins Intensifs, Maisonneuve Rosemont Hospital, Universite de Montreal.

Correspondence to: Yoanna Skrobik, MD, Hopital Maisonneuve Rosemont 5415 boul. de l’Assomption, Montreal, QC, H1T 2M4, Canada; e-mail: yoanna.skrobik@umontreal.ca


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Skrobik is the lead physician in an investigator-initiated research project funded by Hospira; she receives no honoraria or income from that project as all funding serves to fund data collection.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(2):289-290. doi:10.1378/chest.12-1192
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Excessive sedation is harmful, Drs Ely, Dittus, and Girard, and I agree. Much of what is administered in terms of sedation by caregivers aims to relieve suffering, from a position of authority and decision making. In the critically ill patient, the temptation to maintain deep sedation aims to avoid movement, hoping that complications such as self-extubation may be avoided,1 when, in fact, no association exists between wakefulness and removal of catheters or devices.2 The concern that the patient may be experiencing discomfort should indeed be followed by an assessment of the origin of the discomfort rather than by an effort to mask it. This requires a certain degree of stoicism, as well as the skills and interest to identify the source of the patient’s distress. It is apparent that overly sedated patients do not recover quickly or well. Although excess sedation is harmful, benzodiazepine use is not.

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