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Interpreting and Implementing the 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption Clinical Practice Guideline

Balas, Michele C., PhD, RN, CCRN-K, FCCM, FAAN1,2; Weinhouse, Gerald L., MD3,4; Denehy, Linda, PT, PhD5; Chanques, Gerald, MD, PhD6; Rochwerg, Bram, MD, MSc7; Misak, Cheryl J., DPhil8; Skrobik, Yoanna, MD, FRCP(c), MSc, FCCM9; Devlin, John W., PharmD, FCCM10,11; Fraser, Gilles L., PharmD, MCCM12,13

doi: 10.1097/CCM.0000000000003307
Clinical Investigations
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1Center of Excellence in Critical and Complex Care, College of Nursing, The Ohio State University, Columbus, OH.

2The Ohio State University Wexner Medical Center, Columbus, OH.

3Harvard Medical School, Boston, MA.

4Division of Pulmonary and Critical Care, Brigham and Women’s Hospital, Boston, MA.

5Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.

6Department of Anesthesia and Intensive Care, Montpellier University Saint Eloi Hospital, PhyMedExp, University of Montpellier, Montpellier, France.

7Department of Medicine, McMaster University, Hamilton, ON, Canada.

8Department of Philosophy, University of Toronto, Toronto, ON, Canada.

9Faculty of Medicine, McGill University, Montreal, QC, Canada.

10School of Pharmacy, Northeastern University, Boston, MA.

11Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA.

12School of Medicine, Tufts University, Boston, MA.

13Department of Critical Care, Maine Medical Center, Portland, ME.

Although the authors of this article are members of the guideline committee, the views expressed in this article are from a personal perspective and do not represent the collective viewpoint of the guideline committee.

Dr. Balas received funding from Select Medical (primary investigator on research study exploring Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials and Spontaneous Breathing Trials, Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement and empowerment bundle adoption). Dr. Denehy participates in the Australian Physiotherapy Association. Dr. Chanques participates in other healthcare professional organization activities. Dr. Rochwerg participates as a guideline methodologist for other organizations (i.e., American Thoracic Society [ATS] and Canadian Blood Service) in addition to Society of Critical Care Medicine. Dr. Skrobik participates in the ATS and the American College of Chest Physicians, and she is on the editorial board for Intensive Care Medicine and Chest. Dr. Devlin has received research funding from the National Institute of Aging, National Heart, Lung and Blood Institute, and AstraZeneca Pharmaceuticals; is on the editorial board of Critical Care Medicine; and is the president of the American Delirium Society. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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