Over-sedation can increase time on ventilatory support, prolong ICU stay, and may precipitate unnecessary neurological investigations., Sedation should be tailored to the individual needs of the patient.A combination of drugs is often required., A continuous infusion of a benzodiazepine has been identified as an independent predictor of a longer duration of mechanical ventilation, stay in the intensive care unit and stay in hospital., Sedation scores should be used to allow titration of drug administration., The sedation ‘holiday’ strategy has been shown to decrease the duration of mechanical ventilation and length of stay in ICU.When a patient is put in a medically induced coma or deep state of unconsciousness, the brain is able to rest and swelling is more likely to decrease.
Throughout a medically induced coma, a patient’s critical life functions are constantly monitored by an anesthesiologist or other physician in a critical care setting only. A patient who is in a medically induced coma has a brain injury with swelling that has not responded to other treatments.
When the brain swells it can be life-threatening, as it can constrict blood supply and destroy additional brain tissue.
The replacement of an endotracheal tube by a tracheostomy reduces the discomfort associated with an artificial airway and may often remove the need for sedation entirely.
Thus, modern day sedation involves more than tube tolerance and is now focused on the multifactorial individual needs of the patient.
These patients die most commonly as a consequence of struggling and stress!
I once actually witnessed the death of a cardiomyopathic Doberman who struggled and went into ventricular fibrillation while being restrained for an EKG; the owner watched the whole thing!
While there is always an exception to the rule, appropriate sedation is my preference for handling these patients, hands down! before radiographs, IV catheter, thoracocentesis, echocardiogram, etc.
Obviously I would prefer for the dyspneic patient to receive oxygen before, during, and after all interventions, but you've probably noted that some patients will struggle even if you are trying to blow some oxygen in their face; they may need sedation before you can even examine them.
Sedation is often given to allow a patient to be comfortable during a surgical or medical procedure and is administered through an intravenous catheter (IV), with minimal side effects.