Author/Editor     Karim, Habib Mohammad Reazaul; Šarc, Irena; Calandra, Camilla; Spadaro, Savino; Mina, Bushra; Ciobanu, Laura D.; Gonçalves, Gil; Caldeira, Vania; Cabrita, Bruno; Esquinas, Antonio M.
Title     Role of sedation and analgesia during noninvasive ventilation
Type     članek
Vol. and No.     Letnik 26, št. 8
Publication year     2022
Volume     str. 938-948
ISSN     1998-359X - Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
Language     eng
Abstract     Aim: This systematic review aimed to investigate the drugs used and their potential effect on noninvasive ventilation (NIV). Background: NIV is used increasingly in acute respiratory failure (ARF). Sedation and analgesia are potentially beneficial in NIV, but they can have a deleterious impact. Proper guidelines to specifically address this issue and the recommendations for or against it are scarce in the literature. In the most recent guidelines published in 2017 by the European Respiratory Society/American Thoracic Society (ERS/ATS) relating to NIV use in patients having ARF, the well-defined recommendation on the selective use of sedation and analgesia is missing. Nevertheless, some national guidelines suggested using sedation for agitation. Methods: Electronic databases (PubMed/Medline, Google Scholar, and Cochrane library) from January 1999 to December 2019 were searched systematically for research articles related to sedation and analgosedation in NIV. A brief review of the existing literature related to sedation and analgesia was also done. Review results: Sixteen articles (five randomized trials) were analyzed. Other trials, guidelines, and reviews published over the last two decades were also discussed. The present review analysis suggests dexmedetomidine as the emerging sedative agent of choice based on the most recent trials because of better efficacy with an improved and predictable cardiorespiratory profile. Conclusion: Current evidence suggests that sedation has a potentially beneficial role in patients at risk of NIV failure due to interface intolerance, anxiety, and pain. However, more randomized controlled trials are needed to comment on this issue and formulate strong evidence-based recommendations.
Descriptors     Noninvasive ventilation
Analgesia
Neinvazivna ventilacija
Analgezija
Keywords     sedation
respiratory failure
sedacija
dihalna odpoved