Summary
Background. Adequate sedation and analgesia are important aspects of patient care on the intensive therapy unit (ITU), yet current practice is far from ideal and major variations exist.
Methods. We sought to assess interhospital differences in the 36 ITUs of the Silesian region by means of a short questionnaire (25 questions).
Results. We received 29 (80.5%) replies. Only 6 (20.8%) ITUs provided pharmacological sedation for every patient, and 12 units (41.4%) – for all mechanically ventilated patients. 37.8% respondents stated that they used sedation only in excited patients and in those who did not tolerate tracheal intubation. Midazolam, barbiturates and morphine were among the most commonly used drugs. Individual dosage, based on signs of sympathetic activity, assessed mainly by physicians (82.7%) was preferred. When used, the most common sedation scale was the Ramsay scale (24 centers – 82.7%). Bispectral index was used in two centers only. Fifty-five respondents had no written protocol for sedation.
Discussion and conclusion. This study demonstrates that local customs and personal preference based treatment are more commonly used than scientific data in current practice. There is an urgent need for multicenter studies, regular audits and assessment of possible complications and patient comfort.