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Zaključak

Sedacija kritično oboljelih pacijenata u jedinicama intenzivnog liječenja je veoma korisna jer
omogućava brži i kvalitetniji oporavak i smanjuje mortalitet. Sedaciju je potrebno sprovoditi po tačno
utvrđenim kriterijumima, tj. protokolima, uz obavezno prethodno obezbijeđenu analgeziju. Duboku
sedaciju pacijenata treba izbjeći, osim u specifičnim kliničkim stanjima kao što su akutni i subakutni
ARDS i teška trauma mozga. Izbor i doziranje medikamenata za sedaciju zavisi od monitoringa

sedacije koji je obavezan kod ovih pacijenata. Uvođenje protokola sedacije je superiornija metoda od
dnevnih prekida sedacije, zbog smanjenja trajanja mehaničke ventilacije, smanjenja trajanja liječenja
u jedinicama intenzivnog liječenja i ukupnog bolničkog liječenja, kao i smanjenja brojnih komplikacija
koje intenzivno liječenje sa sobom nosi, pa je protokole sedacije neophodno uvesti u kliničku praksu
u svim jedinicama intenzivnog liječenja.

Abstract

Sedation of critically ill patients is a highly important therapeutic aspect in Intensive Care Units (ICUs). Numerous studies
have demonstrated that a sedated (calm) patient compared to an unsedated (restless, agitated, delirious) one achieves
better treatment outcomes, fewer complications, shorter duration of mechanical lung ventilation, reduced ICU stay, shorter
hospitalization, and lower mortality. The fundamental rule is to first ensure analgesia, followed by sedation. Shallow
sedation is recommended to maintain patient cooperation, while deep sedation should be avoided except in specific clinical
situations such as severe brain trauma or acute respiratory distress syndrome.

Monitoring sedation in the ICU is mandatory, and for this purpose, simple scales such as the Richmond Agitation Sedation
Scale (RASS) or the Riker Sedation-Agitation Scale (RSAS) are recommended. There is a wide range of medications available,
each with advantages for specific clinical situations, but generally, propofol and dexmedetomidine are most recommended
and commonly used. Non-pharmacological measures and interventions should also not be disregarded and should be
systematically employed whenever possible to reduce agitation occurrences in the ICU.

Keywords: sedation, agitation, therapy, critical illness, intensive care unit

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