Optimal Sedation in Ventilated Patients with Sepsis and Septic Shock.

Sedation is required to tolerate mechanical ventilation in patients with sepsis and septic shock. Caution should be used with dosing strategies in this patient population. It is recommended that an analgesia-first approach be used, and sedatives added as needed. Propofol and dexmedetomidine are the preferred agents, as recommended by the Society for Critical Care Medicine's 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. Further research is needed for best practices in patients requiring higher-dose sedatives.