Ultimate goal of analgesia and sedation-why and how we protect organs

doi:10.3877/cma.j.issn.2096-1537.2018.03.003

Abstract

Abstract:

Analgesia and sedation are essential for critically ill patients. Now we change our target from patients′ comfort to organ protection. Analgesia and sedation have an important role in reducing respiratory distress, improving synchrony of mechanical ventilation, lowering transpulmonary pressure, reducing oxygen consumption, controlling intracranial pressure and metabolism, optimization of immune and inflammation. An organ protection directed sedation strategy will be more optimal in the future.

Key words: Analgesia, Sedation, Organ protection

Jingyuan Xu, Yi Yang. Ultimate goal of analgesia and sedation-why and how we protect organs[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2018, 04(03): 223-225.

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References 11

1	Schmidt UH,Hess DR. Does spontaneous breathing produce harm in patients with the acute respiratory distress syndrome? [J]. Respir Care, 2010, 55(6): 784-786.
2	Boldt J,Menges T,Kuhn D, et al. Alterations in circulating vasoactive substances in the critically ill–a comparison between survivors and non-survivors [J]. Intensive Care Med, 1995, 21(3): 218-225.
3	Izzo NJ Jr,Seidman CE,Collins S, et al. Alpha 1-adrenergic receptor mRNA level is regulated by norepinephrine in rabbit aortic smoothmuscle cells [J]. Proc Natl Acad Sci U S A, 1990, 87(16): 6268-6271.
4	Talke P,Richardson CA,Scheinin M, et al. Postoperative pharmacokinetics and sympatholytic effects of dexmedetomidine [J]. Anesth Analg, 1997, 85(5): 1136-1142.
5	Geloen A,Chapelier K,Cividjian A, et al. Clonidine and dexmedetomidine increase the pressor response to norepinephrine in experimental sepsis: a pilot study [J]. Crit Care Med, 2013, 41(12): e431-e438.
6	Annane D,Trabold F,Sharshar T, et al. Inappropriate sympathetic activation at onset of septic shock: a spectral analysis approach [J]. Am J Respir Crit Care Med, 1999, 160(2): 458-465.
7	Miranda ML,Balarini MM,Bouskela E. Dexmedetomidine attenuates the microcirculatory derangements evoked by experimental sepsis [J]. Anesthesiology, 2015, 122(3): 619-630.
8	Yeh YC,Sun WZ,Ko WJ, et al. Dexmedetomidine prevents alterations of intestinal microcirculation that are induced by surgical stress and pain in a novel rat model [J]. Anesth Analg, 2012, 115(1): 46-53.
9	Riker RR,Shehabi Y,Bokesch PM, et al. SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial [J]. JAMA, 2009, 301(5): 489-499.
10	Reade MC,Eastwood GM,Bellomo R, et al. Effect of dexmedetomidine added to standard care on ventilator-free time in patients with agitated delirium: A randomized clinical trial [J]. JAMA, 2016, 315(14): 1460-1468.
11	Jang Y,Yeom MY,Kang ES, et al. The antinociceptive effect of dexmedetomidine modulates spleen cell immunity in mice [J]. Int J Med Sci, 2014, 11(3): 226-233.

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