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Editorials: Point/Counterpoint Editorials |

Point: Should All ICU Patients Receive Continuous Sedation? YesICU and Continuous Sedation? Yes

John P. Kress, MD
Author and Funding Information

From the Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago.

Correspondence to: John P. Kress, MD, Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, 5841 S Maryland Ave, MC 6026, Chicago, IL 60637; e-mail: jkress@medicine.bsd.uchicago.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be dis­cussed in this article.

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


Chest. 2012;142(5):1090-1092. doi:10.1378/chest.12-1995
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Extract

Sedative and analgesic drugs are used routinely on patients in the ICU who are mechanically ven­tilated. These drugs can be administered either by continuous infusion or by intermittent IV bolus strategies. The theoretical benefit of a continuous infusion strategy is maintenance of a constant level of drug, leading to improved patient comfort. This strategy is also less taxing on the busy bedside nurse. The potential detriments include a tendency to use more drug(s), which may result in heavier levels of sedation. The theoretical benefit of an intermittent bolus strat­egy is a reduction in the drug amount used and a lesser tendency to oversedate patients; however, this approach may lead to a lower level of patient comfort and a greater burden on the bedside nursing staff. This editorial debate presents an evidence-based summary, highlighting the superiority of the continuous infusion strategy.

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