The paradigm of supportive care of patients who are critically ill has changed significantly over the past 20 years. Patients on mechanical ventilation are no longer heavily sedated; the goal is a comfortable patient who can interact with health-care professionals and with their family members. Systematic, regular assessment of the patient for pain, anxiety, and sleep deprivation allows early recognition of these distressing symptoms. Appropriate treatment of patients' symptoms should be based on a multi-modal pharmacologic and non-pharmacologic approach. Early mobilization and avoidance of physical restraint are additional patient-centered goals. The presence of family members during daily rounds and at the bedside can reduce the distress of the patient and enhance communication with the health-care team. All of these changes have created new challenges and opportunities for the multidisciplinary health-care team. This review aimed to describe the main components of evidence-based supportive care of patients on mechanical ventilation, beyond the specific settings of the ventilator.
Keywords: agitation; analgesia; caregivers; critical illness; delirium; early mobilization; family members; intensive care unit; pain; sedation.
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