RT Journal
A1 Kress JP, Hall JB
T1 THe changing landscape of icu sedation
JF JAMA
JO JAMA
YR 2012
FD November 21
VO 308
IS 19
SP 2030
OP 2031
DO 10.1001/jama.2012.48321
UL http://dx.doi.org/10.1001/jama.2012.48321
AB 
Intubation and mechanical ventilation are essential components of modern intensive care. However, they are also uncomfortable and often intolerable for the patient. Therefore, intensive care clinicians typically prescribe sedation for ventilated patients, hoping to ensure comfort and yet avoid excess or prolonged unconsciousness. Two decades ago, the typical approach was to provide sedation via continuous infusion, with a focus on ensuring comfort and with little awareness of the adverse effects of excessive sedative use in the intensive care unit (ICU).1 However, as reports emerged showing such infusions could unnecessarily prolong the duration of mechanical ventilation and intensive care,2 a variety of evidence-based sedation algorithms for mechanically ventilated patients evolved.