A patient with hypovolemic shock secondary to widespread second- and third-degree burns is being mechanically ventilated
The patient appears agitated, and the respiratory therapist is unable to synchronize the ventilator to the patient. Which drug can the respiratory therapist suggest to the ICU team to sedate this patient and synchronize ventilation?
a. Fentanyl
b. Morphine
c. Propofol
d. Succinylcholine
ANS: A
Fentanyl has minimal effects on the cardiovascular system and does not cause histamine release, as does morphine. It also has minimal effects on the renal system compared with other opioids. Therefore, fentanyl is the opioid of choice for patients with unstable hemodynamic status and renal insufficiency. Morphine and propofol have hemodynamic effects that may worsen this pa-tient's hypovolemia. Succinylcholine is a paralyzing agent. Paralyzing agents should not be given without sedatives.
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