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Semin Respir Crit Care Med 2001; 22(2): 199-210
DOI: 10.1055/s-2001-13833
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Cost Considerations in Sedation, Analgesia, and Neuromuscular Blockade in the Intensive Care Unit

John P. Kress, Jesse B. Hall
  • Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Sedation of critically ill patients is a costly endeavor. Costs of commonly used intensive care unit (ICU) sedatives range from pennies to more than $500 per day. Although the agents account for some of this expense, complications related to the use of these drugs in the ICU produce even greater costs. Prolongation of mechanical ventilation and length of stay are some of the common complications resulting from non-ideal use of these drugs. Sedative agents also impair neurological evaluation in many critically ill patients, which may mask detection of acute delirium resulting from intercurrent illness or intracranial catastrophes and can lead to excessive diagnostic testing. Opiates may result in gastrointestinal dysfunction with resulting malnutrition and perhaps bacterial translocation and sepsis. Neuromuscular blocking agents may cause prolonged paralysis and disability in critically ill patients who receive them. Simple dosing strategies based on pharmacological principles may decrease the incidence of these costly problems.

KEYWORD

Sedation - benzodiazepines - opiates - neuromuscular blocking agents - critical care - costs and cost analysis

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