Side effects of prolonged use of sedative medications in ICU patients: an integrative review
DOI:
https://doi.org/10.62452/fse49f04Keywords:
Sedative medications, adverse reactions, side effects, drug toxicity, intensive care unitAbstract
The use of prolonged sedation in the ICU can be associated with several adverse side effects, primarily caused by the administration of medications such as propofol, etomidate, and dexmedetomidine. Therefore, it is important to consider actions to prevent these effects. The objective of this article is to synthesize the available evidence on the side effects of prolonged use of sedative medications in ICU patients through an integrative review of the specialized literature. An integrative review was conducted. Specialized databases such as PubMed, Scopus, and VHL were used as information sources. A search strategy based on the PCC question, Mesh/DeCS terms, and Boolean operators was followed. Articles from the last 10 years were selected using the Rayyan QCRI® web platform, and a screening process was conducted, ultimately resulting in 17 articles. The PRISMA-ScR guideline, in its extension for integrative reviews, was used, following the checklist and guidelines established by this regulation. Among the selected studies, randomized controlled trials (RCTs), cohort studies, and case studies stand out. Regarding the regions, they were mostly concentrated in Asia and Europe, while only two from Latin America were considered: one from Argentina and one from Brazil. The results of the 17 articles describe adverse events due to the use of benzodiazepines, propofol, and dexmedetomidine, and also provide recommendations for drug combinations such as ketamine and midazolam. The evidence found demonstrates that prolonged use of sedatives causes side effects on the central nervous system, respiratory system, cardiovascular system, thermoregulation, and also has gastrointestinal effects. Therefore, nursing staff must be trained in this regard in order to effectively prevent and intervene in these cases.
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