Title: The Immunological Side-Effects of Sedative Agents in the Intensive Care Unit
Volume: 9
Issue: 3
Author(s): A. Walsh and K. Ghori
Affiliation:
Keywords:
Critical care, sedation, immunosuppression, immunomodulation
Abstract: The immune system is a sophisticated and complex system that is influenced by various exogenous insults such
as surgical stress and endogenous factors like the sympathetic nervous system. It has been demonstrated that sedative
agents used in clinical practice alter the balance of pro- and anti-inflammatory cytokines. These effects may be reversible
following short exposure to anaesthetic agents and sedative drugs. However, many critically ill patients are sedated for
prolonged periods of time, which raises concerns about the risks of immunological interference by sedative agents. When
one considers that sepsis accounts for significant morbidity in intensive care, it is imperative that anything modifiable
which causes immunosuppression is identified. The systemic inflammatory response syndrome is known to feature an increase
in pro-inflammatory mediators, something which could be influenced by sedative agents.
We propose to outline the details surrounding this area, focusing on sedative agents commonly used in the intensive care
setting. A more detailed understanding of this area could lead to improved patient outcomes and have far-reaching influence
on clinical practice in critical care.
