Executive Summary

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

John W. Devlin, PharmD, FCCM; Yoanna Skrobik, MD, FRCP(c), MSc, FCCM; Céline Gélinas, RN, PhD; Dale M. Needham, MD, PhD; Arjen J. C. Slooter, MD, PhD; Pratik P. Pandharipande, MD, MSCI, FCCM; Paula L. Watson, MD; Gerald L. Weinhouse, MD; Mark E. Nunnally, MD, FCCM; Bram Rochwerg, MD, MSc; Michele C. Balas, RN, PhD, FCCM, FAAN; Mark van den Boogaard, RN, PhD; Karen J. Bosma, MD; Nathaniel E. Brummel, MD, MSCI; Gerald Chanques, MD, PhD; Linda Denehy, PT, PhD; Xavier Drouot, MD, PhD; Gilles L. Fraser, PharmD, MCCM; Jocelyn E. Harris, OT, PhD; Aaron M. Joffe, DO, FCCM; Michelle E. Kho, PT, PhD; John P. Kress, MD; Julie A. Lanphere, DO; Sharon McKinley, RN, PhD; Karin J. Neufeld, MD, MPH; Margaret A. Pisani, MD, MPH; Jean-Francois Payen, MD, PhD; Brenda T. Pun, RN, DNP; Kathleen A. Puntillo, RN, PhD, FCCM; Richard R. Riker, MD, FCCM; Bryce R. H. Robinson, MD, MS, FACS, FCCM; Yahya Shehabi, MD, PhD, FCICM; Paul M. Szumita, PharmD, FCCM; Chris Winkelman, RN, PhD, FCCM; John E. Centofanti, MD, MSc; Carrie Price, MLS; Sina Nikayin, MD; Cheryl J. Misak, PhD; Pamela D. Flood, MD; Ken Kiedrowski, MA; Waleed Alhazzani, MD, MSc


Crit Care Med. 2018;46(9):1532-1548. 

In This Article


Under the auspices of the Society of Critical Care Medicine, this executive summary aims to provide the most clinically meaningful and novel aspects, by section, of the PADIS guidelines that clinicians, stakeholders, and decision makers should consider using when improving care for critically ill adults. The recommendation rationales, fueled by rigorous data evaluation, debate, and discussion, circled back to the bedside experience—and the perspective of what was best for patient—held by the panelists and patients involved in producing the guidelines. We believe that the 2018 PADIS guideline[1] will foster the delivery of excellent care regarding pain, agitation/sedation, delirium, immobility, and sleep disruption and stimulate the completion of pragmatic, patient-centered research across each of these important critical care domains.