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Highly Accessed Viewpoint

Intensive care sedation: the past, present and the future

Yahya Shehabi1*, Rinaldo Bellomo2, Sangeeta Mehta3, Richard Riker4 and Jukka Takala5

Author Affiliations

1 University of New South Wales Clinical School, Prince of Wales Hospital, Barker Street, Randwick, NSW 2035, Australia, Australia

2 Faculty of Medicine, University of Melbourne, Melbourne, Department Intensive Care Medicine, The Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia

3 Medical/Surgical ICU, Mount Sinai Hospital, 600 University Avenue #18-216, Toronto, ON, Canada, M5G 1X5

4 Tufts University School of Medicine, Neuroscience Institute and Department of Critical Care Medicine, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, USA

5 Department of Intensive Care Medicine, University Hospital Bern (Inselspital), CH-3010 Bern, Switzerland

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Critical Care 2013, 17:322  doi:10.1186/cc12679

Published: 13 June 2013

Abstract

Despite the universal prescription of sedative drugs in the intensive care unit (ICU), current practice is not guided by high-level evidence. Landmark sedation trials have made significant contributions to our understanding of the problems associated with ICU sedation and have promoted changes to current practice. We identified challenges and limitations of clinical trials which reduced the generalizability and the universal adoption of key interventions. We present an international perspective regarding current sedation practice and a blueprint for future research, which seeks to avoid known limitations and generate much-needed high-level evidence to better guide clinicians' management and therapeutic choices of sedative agents.