Wang Tao, Zhou Dongxu, Zhang Zhongheng, Ma Penglin
Critical Care Medicine Department, Guiqian International General Hospital, Guiyang, China.
Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2021 Nov 12;8:744297. doi: 10.3389/fmed.2021.744297. eCollection 2021.
Suboptimal sedation practices continue to be frequent, although the updated guidelines for management of pain, agitation, and delirium in mechanically ventilated (MV) patients have been published for several years. Causes of low adherence to the recommended minimal sedation protocol are multifactorial. However, the barriers to translation of these protocols into standard care for MV patients have yet to be analyzed. In our view, it is necessary to develop fresh insights into the interaction between the patients' responses to nociceptive stimuli and individualized regulation of patients' tolerance when using analgesics and sedatives. By better understanding this interaction, development of novel tools to assess patient pain tolerance and to define and predict oversedation or delirium may promote better sedation practices in the future.
尽管针对机械通气（MV）患者的疼痛、躁动和谵妄管理的更新指南已发布数年，但次优镇静做法仍然频繁出现。对推荐的最低镇静方案依从性低的原因是多方面的。然而，这些方案转化为MV患者标准护理的障碍尚未得到分析。我们认为，有必要对患者对伤害性刺激的反应与使用镇痛药和镇静剂时患者耐受性的个体化调节之间的相互作用形成新的见解。通过更好地理解这种相互作用，开发评估患者疼痛耐受性以及定义和预测过度镇静或谵妄的新工具，可能会在未来促进更好的镇静实践。
