Drugs used in patient sedation during extracorporeal membrane oxygenation therapy and factors predisposing to the occurrence of delirium – the role of a nurse in prevention

Introduction
From analysis of literature from recent years, it can be seen that delirium in intensive care (IC) is increasingly being examined and diagnosed, and is considered as an indicator of the severity of a patient’s condition. Delirium increases the risk of death, extends the time of IC treatment, and increases the length of hospitalisation. The basic principles of titration and the use of sedatives and analgesics must be adjusted directly to the condition of the patient undergoing extracorporeal membrane oxygenation (ECMO) therapy. The ECMO system has its own unique effect on the pharmacokinetics of each drug. The depth of sedation should also be individually adjusted to the patient’s condition and in cooperation with the entire medical team. An important task of the nurse during ECMO therapy is to assess the patient’s condition.

Aim of the study
The aim of the study is to identify drugs used in patient sedation during ECMO therapy, factors that influence the possibility of delirium in this group of patients, and the role of a nurse in its prevention.

Material and methods
The article is of an illustrative nature; it was developed on the basis of the analysis of the results of scientific research published in peer-reviewed journals in the years 1995-2018 and the authors’ own experience.

Conclusions
Pharmacotherapy applied during ECMO therapy should be selected individually for each patient. The key role of nurses in pain monitoring and sedation should be emphasised using methodologically validated scales and patient care founded on evidence-based medicine.