Updates in optimizing analgesia/sedation strategy for mechanically ventilated patients

Optimization of sedation depth has become one of hot spots for critical care medicine research. Previous multiple studies have demonstrated that deep sedation is associated with poor outcomes in patients with mechanical ventilation. But unnecessary deep sedation remained not rare in our clinical practices owing to complex reasons (partially unknown). Maintaining light rather than deep sedation strategy for patients with mechanical ventilation, therefore, was highly recommended. Meanwhile, it was concerned that the depth of sedation was probably proscribed inappropriately in some of lightly sedated patients largely due to lack of well-predefined contraindications, which even likely increased risk of adverse events in our clinical practices. In addition, increasing publications updated the impacts of analgesia/sedation on immune, gastrointestinal and neural-muscular function in the patients with chronic critical illness, a highly concerned critically ill population. Based on available data, less sedatives and opioids were suggested for these patients. Moreover, "eCASH" concept, a patient-centered, adequate analgesia and light sedation based and humanistic care strengthened comprehensive management strategy was currently proposed to improve the long-term outcomes for patients with mechanical ventilation. It provided us valuable information, in either optimization of clinical practices or research interests, on promoting our medical behaviors and cognition in order to improve patient comfort, safety and clinical outcomes. However, future high-quality clinical researches are needed to verify its feasibility and validity. DOI: 10.11855/j.issn.0577-7402.2017.02.06