Precision Sedation in Intensive Care

Being critically ill and in need of mechanical ventilation is painful and distressing, and patients rarely have the capacity to communicate to express their needs. Doctors and nurses caring for critically ill patients in need of mechanical ventilation are constantly trying to balance patient comfort vs. patient safety. On one hand health care personnel (HCP) want to avoid unnecessary pain and suffering, on the other hand HCP want our patients to be able to communicate and avoid the complications associated with prolonged mechanical ventilation and Intensive Care Unit (ICU) stays. Our current tools for titrating sedation are subjective and variable, leading to large variations in sedation strategy between providers and frequent oversedation to "err on the side of caution". This project is a grassroot initiative where physicians and nurses across various ICUs at Oslo University Hospital are highly motivated to research an alternative strategy for sedation in our units. The investigators believe a more precise approach to sedation that uses neurophysiologic and respiratory targets to guide medication dosing will significantly improve our overall quality of care. By avoiding oversedation, the investigators hope to help our patients wean off mechanical ventilation quicker, reduce their risk of delirium and cognitive deficit, resulting in fewer complications and shorter ICU stays. More precise sedation not only has the potential to improve outcomes for individual patients, but it can also improve ICU capacity and reduce the costs associated with prolonged ICU stays.