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Endotracheal intubation sedation in the intensive care unit

World Journal of Critical Care Medicine 2022年第1期11卷 33-39页

作者： Pritee Tarwade Nathan J Smischney Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States Anesthesiology and Perioperative Medicine Division of Critical Care MedicineMayo ClinicRochesterMN 55905United States

Endotracheal intubation is one of the most common,yet most dangerous procedure performed in the intensive care unit(ICU).Complications of ICU intubations include severe hypotension,hypoxemia,and cardiac *** observational studies have evaluated risk factors associated with these *** the risk factors identified,the choice of sedative agents administered,a modifiable risk factor,has been reported to affect these complications(hypotension).Propofol,etomidate,and ketamine or in combination with benzodiazepines and opioids are commonly used sedative agents administered for endotracheal *** demonstrates rapid onset and offset,however,has drawbacks of profound vasodilation and associated cardiac *** is commonly used in the critically ill ***,it is known to cause reversible inhibition of 11β-hydroxylase which suppresses the adrenal production of cortisol for at least 24 *** added organ impairment with the use of etomidate has been a potential contributing factor for the associated increased morbidity and mortality observed with its *** is known to provide analgesia with sedation and has minimal respiratory and cardiovascular ***,its use can lead to tachycardia and hypertension which may be deleterious in a patient with heart disease or cause unpleasant ***,unlike propofol or etomidate,ketamine requires organ dependent elimination by the liver and kidney which may be problematic in the critically ***,a combination of ketamine and propofol,“ketofol”,has been increasingly used as it provides a balancing effect on hemodynamics without any of the side effects known to be associated with the parent ***,the doses of both drugs are *** situations where a difficult airway is anticipated,awake intubation with the help of a fiberoptic scope or video laryngoscope is *** is a commonly used sedative agent for these proce

关键词： Critically ill Endotracheal intubation Etomidate Hypotension Intensive care unit Ketamine ketofol Propofol Sedation

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