[Evolution and progress of personalized sedation strategies]

Area of Science:

• Critical Care Medicine
• Pharmacology

Background:

• Sedation and analgesia are crucial for critically ill patients, impacting outcomes.
• Clinical practices have shifted significantly in recent years.

Purpose of the Study:

• To review the evolution of sedation strategies in critical care.
• To provide a scientific basis for individualized sedation approaches.

Main Methods:

• Literature review of sedation protocols and agent comparisons.
• Focus on patient populations, clinical effects, and related concepts like delirium and sleep.

Main Results:

• Evolution from deep sedation to light sedation and analgesia-focused models.
• Shift in recommendations favoring propofol and dexmedetomidine over benzodiazepines.
• Exploration of the early comfort using analgesia, minimal sedatives and maximal humane care (eCASH) concept.

Conclusions:

• Clinical sedation strategies have progressed, emphasizing lighter sedation and specific agents.
• Individualized approaches are essential for optimizing care in critically ill patients.