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Figure 3 | Critical Care

Figure 3

From: Strategies to optimize analgesia and sedation

Figure 3

ATICE-based Sedation and Analgesia Algorithm. Adaptation to the Intensive Care Unit Environment (ATICE) is measured every 3 hours, except during the night in patients with satisfactory consciousness at the end of the day. ATICE is measured more frequently in patients with worsening tolerance. The algorithm is not applied while patients are receiving neuromuscular blockers, in the prone position, or after an end-of-life decision has been made. *Stricter objectives of tolerance (calmness = 3, ventilator synchrony = 4) may transiently be used in patients with severe acute respiratory or circulatory failure. †During the initial 48-hour postoperative period, do not decrease fentanyl under 50 to 100 μg/hour. ↓, decrease drug dosage; IV, intravenous; VAS, visual-analog scale. Reprinted with permission from De Jonghe B, Bastuji-Garin S, Fangio P, Lacherade JC, Jabot J, Appere-De-Vecchi C, Rocha N, Outin H: Sedation algorithm in critically ill patients without acute brain injury. Crit Care Med 2005, 33(1):120–127.

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