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July 26, 2000

Measuring Level of Sedation in the Intensive Care Unit—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(4):441-442. doi:10.1001/jama.284.4.436

In Reply: The importance of Dr Ramsay's comments cannot be overemphasized. Care of the critically ill patient requires many interventions that are invasive and uncomfortable. In addition, despite optimum care, many patients do not survive their intensive care stay. Thus, ensuring patient comfort could be considered our first objective: first make them comfortable and then make them better. How is this to be achieved? As an initial step, we need a reliable, valid, and objective measure of changes in comfort levels over time. Second, we need to know which interventions will allow us to most readily achieve the target level of sedation defined by the scoring system and their associated potential for harm.