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Published Online, 14 September 2004, www.theannals.com, DOI 10.1345/aph.1E167.
 The Annals of Pharmacotherapy: Vol. 38, No. 11, pp. 1898-1906. DOI 10.1345/aph.1E167
© 2004 Harvey Whitney Books Company.
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CRITICAL CARE

Sedation Assessment in Critically Ill Adults: 2001–2004 Update

Brian D Watson, PharmD

Critical Care Pharmacy Resident, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA

Sandra L Kane-Gill, PharmD MSc

Assistant Professor, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh; Center for Pharmacoinformatics and Outcomes Research, Pittsburgh

Reprints: Sandra L Kane-Gill PharmD MSc, University of Pittsburgh, Center for Pharmacoinformatics and Outcomes Research, 918 Salk Hall, 3501 Terrace St., Pittsburgh, PA 15261-0001, fax 412/624-1850, KaneSL{at}msx.upmc.edu

OBJECTIVE: To review recently published literature on the validity and reliability of sedation assessment tools in critically ill adults and evaluate the potential advantages and disadvantages of each.

DATA SOURCES: A computerized search of MEDLINE and PubMed (2001–May 2004) was conducted.

STUDY SELECTION AND DATA EXTRACTION: Sedation assessment tools used in adult intensive care units (ICUs) were identified.

DATA SYNTHESIS: Six subjective and 3 objective assessment tools were identified. Four subjective assessment tools have reliability and 4 have validity data published that were not previously available. There are reliability data to further support the use of the previously published Motor Activity Assessment Scale. Additional reliability data exist for the Ramsay Scale and Glasgow Coma Scale. Conflicting evidence is available with the use of the Bispectral Index monitor in the ICU. Recently, the Patient State Index and Auditory Evoked Potentials were introduced for objective monitoring in critically ill patients.

CONCLUSIONS: Increasing data on sedation assessment were published over the last few years, probably in response to supporting evidence that goal-driven sedation therapy improves patient outcomes. Reliability and/or validity testing exists for many of these scales. Several useful tools are available to guide sedation therapy in critically ill patients.

Key Words: assessment tools, critical care, sedation

Published Online, September 14, 2004. www.theannals.com, DOI 10.1345/aph.1E167


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C. N. Sessler and K. Varney
Patient-Focused Sedation and Analgesia in the ICU*
Chest, February 1, 2008; 133(2): 552 - 565.
[Abstract] [Full Text] [PDF]


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