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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Optimal Sedation in Older Critically Ill Adults.

Mark L Rolfsen1, Christina Boncyk2, Robert L Owens3

  • 1Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.

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Older adults in intensive care units (ICUs) face higher risks. This review covers geriatric principles and sedation strategies to improve outcomes for elderly ICU patients.

Keywords:
4 Ms frameworkGeriatricsICULong-term outcomesOlder adultsSedation

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Area of Science:

  • Geriatric Medicine
  • Critical Care Medicine

Background:

  • Global population aging leads to more elderly intensive care unit (ICU) patients.
  • Older adults are vulnerable to critical illness due to geriatric syndromes, resulting in poor outcomes.
  • Sedation is often required for elderly ICU patients but poses significant risks.

Purpose of the Study:

  • To review geriatric principles relevant for ICU clinicians.
  • To discuss sedation choices, strategies, and adjuncts for elderly ICU patients.
  • To explore methods for decreasing sedation exposure and improving patient outcomes.

Main Methods:

  • Literature review of geriatric principles and critical care sedation.
  • Synthesis of current evidence on sedation in older adults.
  • Discussion of clinical strategies for sedation management.

Main Results:

  • Geriatric syndromes impact ICU vulnerability and outcomes in older adults.
  • Sedation management requires tailored approaches considering age-related factors.
  • Specific strategies may reduce sedation exposure and enhance recovery.

Conclusions:

  • Applying geriatric principles is crucial for managing elderly ICU patients.
  • Optimizing sedation strategies can mitigate risks and improve short- and long-term results.
  • Further research into specialized sedation protocols for older adults is warranted.