Question
Which of the following is the preferred drug for continuous sedation of a mechanically ventilated adult patient in the Intensive Care Unit (ICU) according to current critical care practice guidelines?
| A. |
Diazepam
|
| B. |
Lorazepam
|
| C. |
Propofol
|
| D. |
Alprazolam
|
Show Answer
|
Correct Answer » C
Explanation
|
|
- Propofol is the preferred sedative for most mechanically ventilated ICU patients.
- Advantages include:
- Rapid onset (30–60 seconds).
- Short duration of action.
- Easy titration by continuous intravenous infusion.
- Rapid recovery after discontinuation.
- Facilitates early extubation and daily sedation interruption.
- Current SCCM (Society of Critical Care Medicine) guidelines recommend propofol or dexmedetomidine over benzodiazepines for routine ICU sedation.
Why Other Options are Incorrect
A. Diazepam
- Long-acting benzodiazepine.
- Active metabolites accumulate with prolonged use.
- Causes prolonged sedation.
- Not recommended for routine ICU sedation.
B. Lorazepam
- Intermediate-acting benzodiazepine.
- May be used when propofol is contraindicated.
- Associated with prolonged sedation and increased risk of ICU delirium.
- Continuous infusion may cause propylene glycol toxicity.
D. Alprazolam
- Oral benzodiazepine.
- Used for anxiety and panic disorders.
- Not suitable for continuous ICU sedation.
