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