How is sedation provided for percutaneous dilatational tracheostomy in English ICUs?

Excerpt

Percutaneous dilatational tracheostomy (PDT) is commonly performed at the bedside in the ICU. Patients in the ICU often have multiple organ dysfunction, causing alterations in drug effects and metabolism. Alterations in sedative drug handling may make them vulnerable to awareness during PDT. Up to 40% of patients in the ICU report some awareness whilst receiving neuromuscular receptor blocking drugs [1] - these drugs are usually employed when performing PDT. Depth of anaesthesia monitoring may prevent awareness and has been used during PDT [2]. Various depths of anaesthesia monitors are available, including the bispectral index monitor (BIS), the Narcotrend Index and the State and Response Entropy, derived from the EEG. We report the results of a telephone survey on the sedation given for PDT in English ICUs. …