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How to manage withdrawal of sedation and analgesia in mechanically ventilated covid-19 patients?

par Ego, Amedee ;Halenarova, Katarina ;Creteur, Jacques ;Taccone, Fabio
Référence Journal of Clinical Medicine, 10, 21, 4917
Publication Publié, 2021-11

Article révisé par les pairs

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Résumé :

COVID-19 patients suffering from severe acute respiratory distress syndrome (ARDS) require mechanical ventilation (MV) for respiratory failure. To achieve these ventilatory goals, it has been observed that COVID-19 patients in particular require high regimens and prolonged use of sedatives, analgesics and neuromuscular blocking agents (NMBA). Withdrawal from analgosedation may induce a “drug withdrawal syndrome” (DWS), i.e., clinical symptoms of anxiety, tremor, agitation, hallucinations and vomiting, as a result of adrenergic activation and hyperalgesia. We describe the epidemiology, mechanisms leading to this syndrome and our strategies to prevent and treat it.