critical care medicine
Agitation, Confusion, and Neuromuscular Blockade in Critically Ill Patients
Key Points
Agitation, confusion, or both can result from the original medical condition, from complications of the acute illness, from treatment, or from the ICU environment. History and physical examination often suggest a cause and direct subsequent testing. Treat the cause (including giving analgesics for pain and optimizing the environment to minimize confusion) and manage any remaining agitation with a sedative drug such aslorazepam,propofol,dexmedetomidine, orketamine. Neuromuscular blockade merely masks pain and agitation; paralyzed patients may be suffering significantly. 