Current approach to analgesia, sedation and delirium in Critical Care

During their ICU stay, critically ill patients could experience daily episodes of agitation, pain and delirium that might lead to short and long term consequences. A judicious and orderly approach offers these patients an improvement in their prognosis. A rational approach requires the implementation of a series of practices, ideally organized into action protocols, which include the use of tools for the assessment of symptoms, a prioritized, adequate and titrated analgesic treatment, establishing a targeted objective level of sedation, looking for the achievement of superficial sedation levels, with the use of the most appropriate sedative drug, and non-pharmacological strategies for the management of symptoms while involving all members of the professional team and family members into an active participation in the patient's care. The associated effect of these measures provides the basis for the current standard of care for ICU patients, offering opportunities to improve results, comfort and long-term outcomes.