Analgesia, sedation and
delirium management are important parts of
intensive care treatment as they are relevant for patients' clinical and functional long-term outcome. Previous surveys showed that despite this fact implementation rates are still low. The primary aim of the prospective, observational multicenter study was to investigate the implementation rate of
delirium monitoring among intensivists. Secondly, current practice concerning
analgesia and sedation monitoring as well as treatment strategies for patients with
delirium were assesed. In addition, this study compares perceived and actual practice regarding
delirium, sedation and
analgesia management. Data were obtained with a two-part, anonymous survey, containing general data from intensive care units in a first part and data referring to individual patients in a second part. Questionnaires from 101 hospitals (part 1) and 868 patients (part 2) were included in data analysis. Fifty-six percent of the intensive care units reported to monitor for
delirium in clinical routine. Fourty-four percent reported the use of a validated
delirium score. In this respect, the survey suggests an increasing use of
delirium assessment tools compared to previous surveys. Nevertheless, part two of the survey revealed that in actual practice 73% of included patients were not monitored with a validated score. Furthermore, we observed a trend towards moderate or
deep sedation which is contradicting to guideline-recommendations. Every fifth patient was suffering from
pain. The implementation rate of adequate
pain-assessment tools for mechanically ventilated and sedated patients was low (30%). In conclusion, further efforts are necessary to implement guideline recommendations into clinical practice. The study was registered (ClinicalTrials.gov identifier: NCT01278524) and approved by the ethical committee.