Sedation in the ICU: Implications for the long stay patient - Preliminary results

Due to exposure to a wide variety of unpleasant stimuli, such as tracheal suctioning, venipuncture and physiotherapy, most patients admitted to the ICU will require some form of sedation. This paper reviews the limitations of the methods used to quantify the level of sedation, compares the sedation requirements of short-stay and long-stay patients, and presents the preliminary results of a study that investigated the effects of different levels of sedation. Following arrival in the ICU, patients (n = 21) receiving adequate analgesia were randomly assigned to receive propofol infusions to maintain either deep or light sedation for the remainder of the day and overnight. Analyses of plasma catecholamine and cortisol levels and urinary catecholamine levels suggest that heavy sedation of these patients is no more effective than light sedation in reducing the magnitude of the stress response.