Surpassing boundaries: volatile sedation in the NeuroICU

Excerpt

Recent evidence suggests that sedative drug usage in general intensive care unit (ICU) patients should be minimized. Patients should be mobilized early, and each patient’s sedation and analgesia requirements should be evaluated on a daily basis to tailor the care of each individual patient [1, 2]. However, this paradigm change does not apply to acute brain injury patients because in this cohort sedation, along with general targets, has additional aims. Sedative agents, in fact, are administered to critically ill adults with acute brain damage to induce anxiolysis, prevent agitation, and facilitate mechanical ventilation [3]. Additionally, sedation has some neuroprotective properties, improving intracranial pressure (ICP) and cerebral perfusion pressure (CPP), mainly by reducing the cerebral metabolic rate and, in turn, cerebral blood flow and volume [4]. …