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Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Critical Care Medicine · 2018 · Vol. 46(9) · pp. e825–e873

John W. Devlin✉(Northeastern University)Yoanna Skrobik(McGill University)Céline Gélinas(McGill University)Dale M. NeedhamArjen J. C. SlooterPratik P. Pandharipande(Vanderbilt University Medical Center)Paula L. Watson(Vanderbilt University Medical Center)Gerald L. WeinhouseMark NunnallyBram Rochwerg(McMaster University)Michele C. Balas(The Ohio State University Wexner Medical Center)Mark van den Boogaard(Radboud University Medical Center)Karen J. Bosma(London Health Sciences Centre)Nathan E. Brummel(Vanderbilt University Medical Center)Gérald Chanques(Centre National de la Recherche Scientifique)Linda Denehy(Melbourne Health)Xavier DrouotGilles L. FraserJocelyn E. Harris(McMaster University)Aaron M. Joffe(University of Washington)Michelle E. Kho(McMaster University)John P. Kress(University of Chicago)Julie LanphereSharon McKinley(Deakin University)Karin J. Neufeld(Johns Hopkins University)Margaret A. PisaniJean‐François Payen(Université Grenoble Alpes)Brenda T. Pun(Vanderbilt University Medical Center)Kathleen Puntillo(University of California, San Francisco)Richard R. RikerBryce R. H. Robinson(University of Washington)Yahya Shehabi(Monash University)Paul M. Szumita(Brigham and Women's Hospital)Chris Winkelman(Case Western Reserve University)John Centofanti(McMaster University)Carrie Price(Johns Hopkins University)Sina Nikayin(New York Medical College)Cheryl MisakPamela FloodKen KiedrowskiWaleed Alhazzani(Impact)

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Abstract

We found substantial agreement among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults. Highlighting this evidence and the research needs will improve Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) management and provide the foundation for improved outcomes and science in this vulnerable population.

Intensive Care Unit Cognitive Disorders Family and Patient Care in Intensive Care Units Healthcare Decision-Making and RestraintsMedicineDeliriumSedationPopulationGuidelineMEDLINEBest practiceSleep hygieneGrading (engineering)Psychiatry

MeSH terms

Critical CareDeliriumHumansIntensive Care UnitsPainPsychomotor AgitationRestraint, PhysicalSleep Wake DisordersConscious SedationProcedural SedationDeep SedationPain Management

Citations

3,709

FWCI

219.29

field-weighted impact

References

564

Percentile

100%

vs. same field & year

Citations per year

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