Sedation Selection to Reduce Delirium Risk: Why Dexmedetomidine May Be a Better Choice
Document Type
Article
Abstract
In 2018, the Society of Critical Care Medicine published the Pain Agitation Delirium Immobility and Sleep Disruption guidelines that recommend protocol assessment-based pain and sedation management. Since the publication of these guidelines, multiple studies and meta-analyses have been conducted comparing sedative options in the Intensive Care Unit (ICU) setting including dexmedetomidine and propofol. Sedatives are on a continuum when it comes to delirium risk. Propofol, like benzodiazepines, causes changes in sleep patterns by suppressing the rapid eye movement sleep stage not seen with dexmedetomidine, worsening the ICU patient's already poor sleep quality. This reduction in sleep quality increases the risk of delirium. As patient advocates, advanced practice nurses play a vital role in minimizing risk of patient harm. Sedative use and management are areas of opportunity for nurses to minimize this risk. When sedatives are needed, daily sedation vacations should be conducted to re-evaluate the minimum required dose. These practices can reduce sedation risks for delirium and allow for bedside screening and early detection.
Digital Object Identifier (DOI)
Publication Info
Published in Journal of the American Association of Nurse Practitioners, Volume 33, Issue 4, 2021, pages 266-270.
APA Citation
Mulkey, M. A., & Everhart, D. E. (2020). Sedation selection to reduce delirium risk. Journal of the American Association of Nurse Practitioners, 33(4), 1. https://doi.org/10.1097/JXX.0000000000000364
Rights
© 2020 American Association of Nurse Practitioners