The effect of back massage on physiological parameters,dyspnoea, and anxiety in patients with chronic obstructive pulmonary disease in the intensive care unit: A randomised clinical trial

ObjectiveThis study aimed to examine the effect of back massage on physiological parameters, dyspnoea and anxiety in patients with chronic obstructive pulmonary disease receiving noninvasive mechanical ventilation in the intensive care unit.Design and methodsThis study was a randomised controlled trial. Patients in the intervention group received back massage (15 minutes) between 16.00 and 20.00 every day for four days in the intensive care unit. The control group received no intervention. The data was collected using a personal information form, Baseline Dyspnoea Index, State-Trait Anxiety Inventory and Physiological Parameters Chart.ResultsWe found no statistically significant change between systolic-diastolic blood pressures, heart rates and respiratory rate, oxygen saturation and dyspnoea level of the intervention and control groups (p > .05), while there was a significant reduction in the anxiety scores of patients in the intervention group (p < .05).ConclusionThis study found that back massage applied in patients with chronic obstructive pulmonary disease receiving noninvasive mechanical ventilation was effective in decreasing anxiety. Back massage is a low-cost intervention with benefits for patients, and it may be a useful intervention in the anxiety management of intensive care patients.     

Factors associated with anxiety in critically ill patients: A prospective observational cohort study

BackgroundAnxiety is an unpleasant emotion that most intensive care patients experience. This emotion is an important issue in intensive care settings because of its prevalence, adverse effects and severity. Little is known about the factors associated with state and trait anxiety during critical illness.ObjectivesTo describe the patterns of state anxiety reported by intensive care patients, and identify factors associated with state and trait anxiety.DesignProspective observational cohort study.SettingsOne mixed intensive care unit in Brisbane, Australia.ParticipantsAdults (n = 141, ≥18 years) admitted to the intensive care unit for ≥24 h; able to communicate verbally or non-verbally; understand English; and, open their eyes spontaneously or in response to voice.MethodsOutcomes were state anxiety as measured by the Faces Anxiety Scale and trait anxiety as measured by the State-Trait Anxiety Inventory. Pre-intensive care factors tested for possible associations with both state and trait anxiety were: age, gender, marital status, employment status, level of education, smoking status, personality trait of optimism and evidence of mental health care/treatment. Intra-intensive care factors tested were: reason for admission to the intensive care unit, delirium, pain, airway status, hours of mechanical ventilation, severity of illness, days of stay in intensive care, exposure to corticosteroids, opioids, benzodiazepines, anxiolytics, antidepressants, beta-blockers, anaesthetic agents and analgesics; length of sedation and analgesia and total doses of sedatives and analgesics.ResultsOf 141 participants, 98 (70%) were male with an average age of 54 (standard deviation: ±15) years and stayed in intensive care for about 4 (Interquartile Range: 3–7) days. The majority (n = 115; 82%) of participants experienced state anxiety at least once during their stay in intensive care, with 57% reporting moderate to severe levels. Factors related to state anxiety in intensive care were pain and trait anxiety. Factors associated with trait anxiety were trait optimism, state anxiety, evidence of mental health care/treatment and age.ConclusionsThis study provides a better understanding of contributing factors for anxiety in the critically ill. Trait anxiety and state anxiety were significantly associated with each other, namely, patients who were anxious by nature experienced higher levels of state anxiety, which persisted throughout their stay in the intensive care unit. Recognising the importance of state and trait anxiety assessments using validated tools and determining ways to manage anxiety in the critically ill are critical aspects of the intensive care nurses role.     

Intra-hospital transfer anxiety of patients in the neurosurgery intensive care unit: A prospective cohort study

BackgroundTransferring a patient from the intensive care unit to different locations within the hospital can cause transfer anxiety. Transfer anxiety is an important factor that adversely affects various physiological and psychological parameters.ObjectiveThe aim of the study is to evaluate the intra-hospital transfer anxiety of patients in a neurosurgery intensive care unit and factors affecting it.MethodsThis prospective cohort study was conducted between November 2021 and June 2022 in a neurosurgery intensive care unit in Istanbul. A total of 171 adult patients who stayed in the intensive care unit for at least 24 h, with a Glasgow Coma Scale score of 14 and above and who had undergone their first intra-hospital transfer were included. Patients’ vital signs were recorded, and their anxiety levels were assessed using the State-Trait Anxiety Inventory.ResultsThe mean age of the patients was 53.16 ± 15.51 years and 56.72% were women, 75.43% of transfers were performed during the day and 64.32% of patients were transferred to an in-patient ward. Factors affecting transfer anxiety were gender, employment status, timing, and purpose of transfer (p < 0.05). Blood pressures and heart rates tended to increase during transfer and decrease again after transfer, while oxygen saturation decreased during transfer (p = 0.035) and increased again after transfer (p < 0.001). State anxiety levels were moderate before transfer and decreased to mild level after transfer (p < 0.001).ConclusionsThe transfer process increased anxiety and caused changes in the vital signs of intensive care patients. Individual and transfer-related factors may influence transfer anxiety. Patients should be monitored for transfer anxiety and nursing interventions to reduce anxiety should be planned.Implications for clinical practiceThe patients’ demographics and transfer details can influence transfer anxiety. Transfer anxiety can affect both subjective parameters and objective measures such as vital signs. Patients at risk of transfer anxiety should be identified before transfers so that nursing interventions to reduce anxiety can therefore be planned.     

Self-efficacy of caring for patients in the intensive care unit with delirium: Development and validation of a scale for intensive care unit nurses

BackgroundImproving the self-efficacy of intensive care unit nurses for delirium care could help them adapt to the changing situation of delirium patients. Validated measures of nurses' self-efficacy of delirium care are lackingObjectivesThe objective of this study was to develop a Delirium Care Self-Efficacy Scale for assessing nurses' confidence about caring for patients in the intensive care unit and to examine the scale's psychometric properties.MethodsDraft scale items were generated from a review of relevant literature and face-to-face interviews with intensive care unit nurses; content validity was conducted with a panel of five experts in delirium. A group of nurses were recruited by convenience sampling from intensive care units (N = 299) for item analysis of the questionnaire, assessment of validity, and reliability of the scale. Nurse participants were recruited from nine adult critical care units affiliated with a hospital in Taiwan. Data were collected from August 2020 to July 2021.ResultsContent validity index was 0.98 for the initial 26 items, indicating good validity. The critical ratio for item discrimination was 14.47–19.29, and item-to-total correlations ranged from 0.67 to 0.81. Principal component analysis reduced items to 13 and extracted two factors, confidence in delirium assessment and confidence in delirium management, which explained 66.82% of the total variance. Cronbach's alpha for internal consistency was 0.94 with good test–retest reliability (r = 0.92). High scale scores among participants were significantly associated with age (≥40 years), work experience in an intensive care unit (≥10 years), delirium education, and willingness to use delirium assessment tools.ConclusionsThe newly developed Delirium Care Self-Efficacy Scale demonstrated acceptable reliability and validity as a measure of confidence for intensive care nurses caring for and managing patients with delirium in the intensive care unit.     

Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

ObjectivesThis study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.Research methodology/designProspective multicentre cohort study.SettingIn all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.ResultsIn total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No significant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (±19) in 14 units and estimated 59% (±29) in the other 14.ConclusionDelirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place.     

Effects of an interactive handgrip game on surgical patients requiring intensive care: An assessor-blinded randomized controlled trial

ObjectiveTo explore the effect of an interactive handgrip game on psychological distress and handgrip strength among critically ill surgical patients.DesignA randomised controlled trial.SettingA surgical intensive care unit.InterventionParticipants were enrolled in the program within 48 hours of admission to the intensive care unit. Patients in the intervention group played a 20-minute interactive handgrip game twice daily for a maximum of three days in the intensive care unit in addition to routinely passive physical rehabilitation. Patients in the routine care group had a daily target of 20 min of passive physical rehabilitation as needed.MeasurementThe primary outcomes included depression, anxiety, and stress measured using the shortened version of the Depression Anxiety Stress Score scale. The secondary outcomes were perceived sleep evaluated using the Richards–Campbell Sleep Questionnaire, delirium assessed using the Intensive Care Delirium Screening Checklist, and handgrip strength measured using handgrip dynamometry within a handgrip device.ResultsTwo hundred and twenty-seven patients were eligible and 70 patients were recruited in the intervention (n = 35) and routine care groups (n = 35). The patients in the intervention group had lower scores (median = 6.0, 4.0, and 12.0) for depression, anxiety, and stress compared with those in the routine care group (12.0, 12.0, and 20.0; all p < 0.05). The interactive handgrip game did not significantly improve sleep quality and prevent the occurrence of delirium (both p > 0.05). The patients who received the interactive handgrip game intervention exhibited significantly enhanced handgrip strength in both hands over time (both p < 0.001).ConclusionAn interactive handgrip game may benefit the psychological well-being and handgrip strength of critically ill patients.Implications for Clinical PracticeInteractive handgrip games is effective active exercise which should be integrated into routine nursing practice.     

Efecto de la música sobre la ansiedad y el dolor en pacientes con ventilación mecánica

The power of music to relieve anxiety or pain has been widely used throughout history.ObjectiveTo evaluate effects of music on anxiety and pain in patients on invasive mechanical ventilation.DesignA randomized controlled trial with repeated measures.Material and methodThis was a randomized, experimental prospective study in a tertiary hospital conducted from January 2009 to June 2010. The sample was made up of 44 participants. Intervention consisted in a 30-minute musical session in which the subject used a headset and was in an individual room. For the control group, the usual setting of an intensive care unit was maintained unchanged. Each patient underwent a minimum of 3 and maximum of 5 sessions. The patient per se selected the music from among a selection prepared by the investigator team. Anxiety and pain and hemodynamic variables of heart rate, respiratory rate systolic and diastolic blood pressure were measured at baseline, after the music session and then one-hour later.ResultsMusic therapy significantly decreased anxiety score (P = .000) when measured with the State-Trait Anxiety Inventory (STAI) scale. There were no differences in pain in the experimental group (P = .157) when measured with the visual analogue scale. No summative effects were demonstrated during multiple sessions.ConclusionMusic reduces anxiety in patients with invasive mechanical ventilation. Invasive mechanical ventilation can be established as a non-pharmacologic tool added to the available therapeutic options.     

Influence of sedation on delirium recognition in critically ill patients: A multinational cohort study

BackgroundGuidelines advocate intensive care unit (ICU) patients be regularly assessed for delirium using either the Confusion Assessment Method for the ICU (CAM-ICU) or the Intensive Care Delirium Screening Checklist (ICDSC). Single-centre studies, primarily with the CAM-ICU, suggest level of sedation may influence delirium screening results.ObjectiveThe objective of this study was to determine the association between level of sedation and delirium occurrence in critically ill patients assessed with either the CAM-ICU or the ICDSC.MethodsThis was a secondary analysis of a multinational, prospective cohort study performed in nine ICUs from seven countries. Consecutive ICU patients with a Richmond Agitation-Sedation Scale (RASS) of −3 to 0 at the time of delirium assessment where a RASS ≤ 0 was secondary to a sedating medication. Patients were assessed with either the CAM-ICU or the ICDSC. Logistic regression analysis was used to account for factors with the potential to influence level of sedation or delirium occurrence.ResultsAmong 1660 patients, 1203 patients underwent 5741 CAM-ICU assessments [9.6% were delirium positive; at RASS = 0 (3.3% were delirium positive), RASS = −1 (19.3%), RASS = −2 (35.1%); RASS = −3 (39.0%)]. The other 457 patients underwent 3210 ICDSC assessments [11.6% delirium positive; at RASS = 0 (4.9% were delirium positive), RASS = −1 (15.8%), RASS = −2 (26.6%); RASS = −3 (20.6%)]. A RASS of −3 was associated with more positive delirium evaluations (odds ratio: 2.31; 95% confidence interval: 1.34–3.98) in the CAM-ICU–assessed patients (vs. the ICDSC-assessed patients). At a RASS of 0, assessment with the CAM-ICU (vs. the ICDSC) was associated with fewer positive delirium evaluations (odds ratio: 0.58; 95% confidence interval: 0.43–0.78). At a RASS of −1 or −2, no association was found between the delirium assessment method used (i.e., CAM-ICU or ICDSC) and a positive delirium evaluation.ConclusionsThe influence of level of sedation on a delirium assessment result depends on whether the CAM-ICU or ICDSC is used. Bedside ICU nurses should consider these results when evaluating their sedated patients for delirium. Future research is necessary to compare the CAM-ICU and the ICDSC simultaneously in sedated and nonsedated ICU patients.Trial registrationClinicalTrials.gov; NCT02518646     

Risk factors and outcomes of sepsis-associated delirium in intensive care unit patients: A secondary data analysis

ObjectiveTo identify the risk factors of sepsis-associated delirium and determine their effect on intensive care unit adult patient outcomes.DesignA secondary analysis of data from system development studies.SettingKorean intensive care unit patients in a university hospital who were diagnosed with sepsis.MethodsThe risk factors for sepsis-associated delirium were classified into patient factors and sepsis clinical features and were analysed using hierarchical logistic regression analysis. Outcomes included in-hospital mortality, 30-day in-hospital mortality, duration of mechanical ventilation, length of stay in the intensive care unit, length of hospital stay, total medical expenses, discharge placement, re-hospitalisation and visits to the emergency department after discharge.ResultsThe risk factor for sepsis-associated delirium including patients aged 65 ≥years, dependent activity and high nursing needs (patient factors), low level of consciousness, tachypnoea, and thrombocytopaenia (clinical features of sepsis). Use of vasopressors/inotropes and albumin decreased the risk of sepsis-associated delirium. Mechanical ventilation duration was prolonged and discharge to skilled nursing facilities was increased by sepsis-associated delirium.ConclusionsThe risk factors for sepsis-associated delirium increased as the severity of condition for patients with sepsis increased. Early identification of risk factors associated with sepsis-associated delirium may improve patient outcomes.     

Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools

ObjectivesTo inform design of quality improvement tools specific to patients with prolonged intensive care unit stay, we determined characteristics (format/content), development, implementation and outcomes of published multi-component quality improvement tools used in the intenisve care unit irrespective of length of stay.Research MethodologyScoping review searching electronic databases, trial registries and grey literature (January 2000 to January 2022).ResultsWe screened 58,378 citations, identifying 96 studies. All tools were designed for use commencing at intensive care unit admission except three tools implemented at 3, 5 or 14 days. We identified 32 studies of locally developed checklists, 28 goal setting/structured communication templates, 23 care bundles and 9 studies of mixed format tools. Most (43 %) tools were designed for use during rounds, fewer tools were designed for use throughout the ICU day (27 %) or stay (9 %). Most studies (55 %) reported process objectives i.e., improving communication, care standardisation, or rounding efficiency. Most common clinical processes quality improvement tools were used to standardise were sedation (62, 65 %), ventilation and weaning (55, 57 %) and analgesia management (58, 60 %). 44 studies reported the effect of the tool on patient outcomes. Of these, only two identified a negative effect; increased length of stay and increased days with pain and delirium.ConclusionAlthough we identified numerous quality improvement tools for use in the intensive care unit, few were designed to specifically address actionable processes of care relevant to the unique needs of prolonged stay patients. Tools that address these needs are urgently required.Systematic review registration: The review protocol is registered on the Open Science Framework, https://osf.io/, DOI 10.17605/OSF.IO/Z8MRE     

Efecto de la musicoterapia sobre la ansiedad y el dolor en el paciente crítico politraumatizado

ObjectiveTo determine the effectiveness of music therapy on anxiety and pain in critical polytraumatised patients admitted to the resuscitation unit of a tertiary level hospital in Spain.Material and methodRandomised clinical trial conducted in a tertiary level hospital, from June 2016 to May 2018. The study sample was 60 patients, 30 belonging to the intervention group (IG), and 30 to the control group (CG). The IG were given a 30-minute music session and heart rate (HR) and blood pressure (BP) were measured. The VAS (Visual Analogue Scale) was applied for anxiety and pain before and after each session. The same measures and scales were applied in the CG who did not receive a music session. The music session comprised 3 parts: the first was standard music selected by music therapists; the second was personalised, chosen by the patient and the third was a new standard. The intervention took place in a booth with headphones.ResultsSignificant changes in anxiety levels (P < .01) were detected in the group of patients undergoing the intervention, measured with the VAS scale for anxiety, and pain levels (P < .01), measured with the VAS scale for pain. No significant differences were found in the physiological parameters of HR and BP.ConclusionThe use of music in critical polytraumatised patients reduces anxiety and pain levels, increasing the patient's well-being and improving the quality of care. Music therapy, therefore, is considered beneficial as a complementary measure in critical care units. It would be worthwhile to continue studies in this and other hospital areas.     

Delirium prevalence and prevention in patients with acute brain injury: A prospective before-and-after intervention study

ObjectivesKnowledge regarding delirium prevention in patients with acute brain injury remains limited. We tested the hypothesis that an intervention bundle which targeted sedation, sleep, pain, and mobilisation would reduce delirium in patients with acute brain injury.DesignA prospective before-after intervention study: a five-month phase of standard care was followed by a six-month intervention phase.SettingThe neuro-intensive care unit, University Hospital of Copenhagen, Denmark.Main outcome measuresThe Intensive Care Delirium Screening Checklist was used to detect delirium. Primary outcome was delirium duration; secondary outcomes were delirium prevalence, ICU length of stay and one year mortality.ResultsForty-four patients were included during the standard care phase, and 50 during the intervention phase. Delirium was present in 90% of patients in the standard care group and 88% in the intervention group (p = 1.0), and time with delirium was 4 days vs 3.5 days (p = 0.26), respectively. Also, ICU length of stay (13 vs. 10.5 days (p = 0.4)) and the one year mortality (21% vs 12% (p = 0.38))) were similar between groups.ConclusionWe found a high prevalence of delirium in patients with acute brain injury. The intervention bundle did not significantly reduce prevalence or duration of delirium, ICU length of stay or one year mortality.     

Incidence and influencing factors of post-intensive care cognitive impairment

ObjectiveTo evaluate the incidence and risks factors of short-term post-intensive care (ICU) cognitive impairment.DesignProspective, observational study.SettingClosed university-affiliated intensive care unit.PatientsWe enrolled consecutive patients >18 yrs of age expected to be in intensive care unit for ≥24 hours.InterventionsNone.Measurements and main resultsThe score of Montreal Cognitive Assessment (MoCA) less than 26 was defined as cognitive impairment at hospital discharge and short-term post-ICU cognitive impairment was diagnosed in 185 of 409 assessed patients (45.2%). According to univariate analysis, age, years of education, occupation, past medical history, main ICU diagnosis, Acute Physiology and Chronic Evaluation Scoring System (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, Charlson comorbidity index, ICU length-of-stay (LOS), total hospital LOS, sedation, vasoactive agents, muscle relaxants, mechanical ventilation and duration of mechanical ventilation, constraints, early active mobilisation, hypoxemia, frequency and severity of delirium, blood pressure, rescue experience, and infection were significant predictors of post-ICU cognitive impairment. Multivariate analysis results showed that the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors.ConclusionsIncidence of post-ICU cognitive impairment is at a high level, which is similar to former researches’ results; the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors of post-ICU cognitive impairment.     

Use of Virtual Reality for Reducing Pain and Anxiety After Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial

AimThe present study aimed to evaluate the effect of virtual reality on pain and anxiety in patients who had undergone laparoscopic sleeve gastrectomy.MethodThe study was conducted between September 1, 2019, and December 31, 2019, in the surgical intensive care unit at a government hospital. The participants were 110 patients who met the inclusion criteria and agreed to participate in the study. According to the study procedure, while the control group received standard care, the intervention group watched a virtual reality video. Data were collected with a personal information form, the Numeric Pain Rating Scale, and the Faces Anxiety Scale.ResultsThe mean post-test Numeric Pain Rating Scale score was significantly lower in the intervention group than in the control group (p < .001). However, the mean Faces Anxiety Scale scores did not differ significantly between the groups (p = .087).ConclusionsVirtual reality can effectively reduce pain and anxiety in patients who have undergone laparoscopic sleeve gastrectomy in intensive care units.     

The effect of video visitation on intensive care unit patients and family members outcomes during the COVID-19 pandemic: A randomised controlled trial

ObjectiveTo investigate the effect of video visitation on intensive care patients’ and family members’ outcomes during the COVID-19 pandemic.DesignThis is a randomised controlled trial.SettingAn adult intensive care unit in a tertiary hospital in Beijing, China.MethodsA total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital.ResultsThere were no statistically significant differences between the groups in patients’ anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members’ anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members’ satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05).ConclusionVideo visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members’ satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients’ and family members’ outcomes.Implications for clinical practiceVideo visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.     

Factors related to memory absence and delusional memories in patients in intensive care units managed with light sedation

ObjectivesCurrently, light sedation is typically given to patients in intensive care units and studies have not extensively examined the factors related to absences or abnormalities of their memories. We, therefore, analysed the factors related to the absence/abnormalities of patients’ memories in intensive care units.Research MethodologyA secondary analysis of previously collected survey data examining patients’ experiences in an intensive care unit was undertaken (n = 405; women = 38%; median age = 70 years). To observe absent or distorted memories, patients were interviewed after leaving the intensive care unit. We analysed key factors through content analysis of the interviews and field notes.SettingThe intensive care unit of a university hospital. Main outcome measure: Patients’ absent or distorted memories after leaving the intensive care unit.ResultsHalf the patients reported an absence of memories. This was associated with old age and with longer duration of mechanical ventilation. Absent or fragmentary memories were not distressing. Fragmentary and fearful intensive care unit memories were associated with being older. Delusional memories, some of which reflected actual events, were present in 3% of patients.ConclusionAbsence of memories were not distressing, delusional memories occurred less and these memories could comprise of an event in ICU that is difficult for patients to understand.     

重症监护病房患者镇痛镇静的研究进展

镇痛镇静治疗已经成为重症监护病房中综合治疗的重要组成部分,可以消除或减轻患者的疼痛及不适,控制焦虑、躁动和谵妄,减轻应激反应,改善患者睡眠、诱导遗忘,提高机械通气的协调性,减轻医疗护理操作对患者造成的伤害性刺激,使危重患者处于舒适和安全的理想水平。本文对重症监护病房患者镇痛镇静的研究进展进行综述。