Sedation and chemical relaxation in critical pulmonary illness: suggestions for patient assessment and drug monitoring.

Anxiety, fear, and pain are common occurrences for patients with acute respiratory failure. These symptoms may influence patients' ability to tolerate mechanical ventilation because of the development of asynchronous breathing patterns. The administration of sedatives and neuromuscular blocking agents may be necessary to facilitate ventilation and enhance oxygenation. Few published protocols exist to guide clinicians in initiating and effectively monitoring patients receiving these agents. In this article, the author focuses on the identification of patients for whom these drugs may be indicated, describes protocols currently available, and offers suggestions for improving patient monitoring to avoid the development of adverse events.

Respiratory pharmacology and the weaning patient: implications for critical care nursing.

The process of weaning patients from mechanical ventilation may be facilitated by the appropriate selection and use of bronchodilators, mucolytics, steroids, and sedatives. This article discusses implications for the critical care nurse, focusing on the indications, applications, and evaluations of the drugs most commonly administered to patients prior to or during weaning from mechanical ventilation.