病危病人的鎮靜照護

Sedative Care of Critically Ill Patients

在加護中心接受加強照護的病人可能因疾病的本身、侵入性管路帶來的不適及加護病房環境的刺激源，而常發生躁動的現象。躁動可能進一步導致合併症，甚至死亡，因此，鎮靜照護對病危病人更顯得重要。本文針對躁動的定義、臨床徵象和症狀、引起躁動的原因及鑑別診斷、躁動的照護與實證研究、鎮靜治療的評估工具，做一文獻回顧，以提供臨床人員對病危病人之鎮靜照護的參考。

Agitation frequently occurs among the critically ill patients in the intensive care unit (ICU). The agitation syndrome may be caused by many factors, including the underlying illnesses, discomfort associated with invasive catheterization and intubation, and many stimulus common to the ICU environment. The syndrome complicates management in the ICU, often leading to further morbidity and complications. Therefore, sedative care is very important to critically ill patients. In this review article, we described the definition, signs, and symptoms of agitation. In addition, we discussed factors contributing to agitation, differential diagnosis of agitation, care of agitation and researches of evidence base in sedative care, scales, and tools to monitor agitation. This article may serve as a useful reference in clinical practice for sedative care.