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

作者：Kimberley Lewis, Michele C. Balas, Joanna L. Stollings, Molly McNett, Timothy D. Girard, Gérald Chanques, Michelle E. Kho, Pratik P. Pandharipande, Gerald L. Weinhouse, Nathan E. Brummel, Linda L. Chlan, Makayla Cordoza, Jeremiah J. Duby, Céline Gélinas, Erin L. Hall-Melnychuk, Anna Krupp, Patricia Louzon, Judith A. Tate, Bethany Young, Ron Jennings, Anitra Hines, Chris Ross, Kallirroi Laiya Carayannopoulos, Janet Aldrich · 发表于：Critical Care Medicine · 年份：2025 · DOI：10.1097/ccm.0000000000006574 · 被引用次数：226 · 研究领域：Intensive Care Unit Cognitive Disorders、Family and Patient Care in Intensive Care Units、Sepsis Diagnosis and Treatment

RATIONALE: Critically ill adults are at risk for a variety of distressing and consequential symptoms both during and after an ICU stay. Management of these symptoms can directly influence outcomes. OBJECTIVES: The objective was to update and expand the Society of Critical Care Medicine's 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PANEL DESIGN: The interprofessional inclusive guidelines task force was composed of 24 individuals including nurses, physicians, pharmacists, physiotherapists, psychologists, and ICU survivors. The task force developed evidence-based recommendations using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Conflict-of-interest policies were strictly followed in all phases of the guidelines, including task force selection and voting. METHODS: The task force focused on five main content areas as they pertain to adult ICU patients: anxiety (new topic), agitation/sedation, delirium, immobility, and sleep disruption. Using the GRADE approach, we conducted a rigorous systematic review for each population, intervention, control, and outcome question to identify the best available evidence, statistically summarized the evidence, assessed the quality of evidence, and then performed the evidence-to-decision framework to formulate recommendations. RESULTS: The task force issued five statements relat...