Actualización del protocolo de sedoanalgesia en una unidad de cuidados intensivos adultos de un hospital de alta complejidad : lugar de desarrollo Hospital Clínico San Borja Arriará
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Fecha
2022
Profesor/a Guía
Facultad/escuela
Idioma
es
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Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
En los pacientes UCI que están conectados a ventilación mecánica invasiva, se
pueden presentar situaciones de estrés, ansiedad, agitación y dolor que conlleva a un
desorden de sueño, desorientación, taquicardia, etc., ya que es un proceso artificial y
donde se utiliza una máquina que se encuentra interactuando con el paciente. Hasta
el 40% de los pacientes refieren haber sufrido dolor en algún momento de su estadía
en UCI. La sedo analgesia es uno de los pilares fundamentales en el manejo del
paciente crítico que estén conectados a VMI y podemos definirlo en dos conceptos:
analgesia es la más importante, ya que, siempre buscaremos el bienestar del paciente
y en este contexto es que se encuentre sin dolor durante los procesos y las
intervenciones. La sedación busca el confort del paciente y que este sea capaz de
aportar en los procesos de su recuperación, disminuyendo la ansiedad, agitación y
tolerancia a la VMI.
Esta nueva versión del protocolo se realizará bajo la misma modalidad de escalones
de fármacos y siempre en combinación, para tener buenos resultados de analgesia
principalmente y de sedación. Está dirigido a pacientes que ingresen a la UCI adultos
de UPC del HCSBA, que requieran VMI a través de un tubo orotraqueal (TOT).
Objetivos: Actualizar el Protocolo Farmacológico de Sedo analgesia vigente en la
Unidad de Cuidados Intensivos adulto de un hospital clínico docente asistencial.
Criterios de inclusión: Pacientes >18 años, hospitalizados en UCI, que requieren
ventilación mecánica invasiva > 24 horas.
Este proyecto contará con dos etapas fundamentales, las cuales son la etapa previa a
la actualización o etapa observacional y la etapa experimental, donde se
recomendarán las nuevas opciones farmacológicas. Además, se revisarán los
objetivos de SAS, de acuerdo con la meta diaria propuesta por el médico tratante, la
escala de sedo analgesia y el tiempo de despertar de los pacientes en concordancia a
las metas propuestas.
Se evaluará la optimización de los fármacos, para los dos tipos de sedación (superficial
y profunda), de igual manera se hará bajo las propuestas realizadas por el médico y
por los requerimientos del paciente que cumplan con los criterios de selección
propuestos. Además, se incluirán recomendaciones que ayudarán a que se cumpla de
buena manera la incorporación del nuevo protocolo y se realizará una evaluación de
costo-efectividad de los medicamentos involucrados.
In ICU patients who are connected to invasive mechanical ventilation, situations of stress, anxiety, agitation and pain may occur, leading to sleep disorder, disorientation, tachycardia, etc., since it is an artificial process and where a machine that interacts with the patient is used. Up to 40% of patients report having suffered pain at some time during their stay in the ICU. Sedation and analgesia is one of the fundamental pillars in the management of critical patients who are connected to VMI and we can define it in two concepts: analgesia is the most important, since we will always seek the patient's well-being and in this context is that the patient is pain-free during the processes and interventions. Sedation seeks the patient's comfort and that he/she is able to contribute to the recovery process, reducing anxiety, agitation and tolerance to VMI. This new version of the protocol will be carried out under the same modality of drug steps and always in combination, in order to have good results mainly in analgesia and sedation. It is aimed at patients admitted to the adult ICU of the HCSBA CPICU, who require IMV through an orotracheal tube (OTT). Objectives: To update the Pharmacological Protocol of Sedo analgesia in force in the adult Intensive Care Unit of a clinical teaching hospital. Inclusion criteria: Patients >18 years old, hospitalized in ICU, requiring invasive mechanical ventilation > 24 hours. This project will have two fundamental stages, which are the pre-update or observational stage and the experimental stage, where new pharmacological options will be recommended. In addition, the SAS objectives will be reviewed, according to the daily goal proposed by the treating physician, the analgesia sedation scale and the patients' awakening time in accordance with the proposed goals. The optimization of the drugs will be evaluated for the two types of sedation (superficial and deep), as well as the proposals made by the physician and the patient's requirements that meet the proposed selection criteria. In addition, recommendations will be included that will help the incorporation of the new protocol and a costeffectiveness evaluation of the drugs involved will be carried out.
In ICU patients who are connected to invasive mechanical ventilation, situations of stress, anxiety, agitation and pain may occur, leading to sleep disorder, disorientation, tachycardia, etc., since it is an artificial process and where a machine that interacts with the patient is used. Up to 40% of patients report having suffered pain at some time during their stay in the ICU. Sedation and analgesia is one of the fundamental pillars in the management of critical patients who are connected to VMI and we can define it in two concepts: analgesia is the most important, since we will always seek the patient's well-being and in this context is that the patient is pain-free during the processes and interventions. Sedation seeks the patient's comfort and that he/she is able to contribute to the recovery process, reducing anxiety, agitation and tolerance to VMI. This new version of the protocol will be carried out under the same modality of drug steps and always in combination, in order to have good results mainly in analgesia and sedation. It is aimed at patients admitted to the adult ICU of the HCSBA CPICU, who require IMV through an orotracheal tube (OTT). Objectives: To update the Pharmacological Protocol of Sedo analgesia in force in the adult Intensive Care Unit of a clinical teaching hospital. Inclusion criteria: Patients >18 years old, hospitalized in ICU, requiring invasive mechanical ventilation > 24 hours. This project will have two fundamental stages, which are the pre-update or observational stage and the experimental stage, where new pharmacological options will be recommended. In addition, the SAS objectives will be reviewed, according to the daily goal proposed by the treating physician, the analgesia sedation scale and the patients' awakening time in accordance with the proposed goals. The optimization of the drugs will be evaluated for the two types of sedation (superficial and deep), as well as the proposals made by the physician and the patient's requirements that meet the proposed selection criteria. In addition, recommendations will be included that will help the incorporation of the new protocol and a costeffectiveness evaluation of the drugs involved will be carried out.
Notas
Seminario (Química Farmacéutica)
Palabras clave
Analgesia, Sedantes, Normas, Cuidados Intensivos