Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation.

Over the last decade a vast body of literature has been generated regarding different sedation strategies, with the aim of reducing the levels of sedation in critically ill patients.

There has also been a growing interest in acute brain dysfunction, or delirium, in the ICU. However, the effect of sedation during ICU stay upon long-term cognitive deficits in ICU survivors remains unclear.

Strategies for reducing sedation levels in the ICU do not seem to be associated with worse cognitive and psychological status among ICU survivors.

Sedation strategy and management efforts therefore should seek to secure the best possible state in the mechanically ventilated patient and lower the prevalence of delirium, in order to prevent long-term cognitive alterations.

With the scarcity of the literature available, it would be premature to attempt to draw any firm conclusions on the impact of sedation during critical illness and its role in long-term cognitive deficit.

The lack of studies designed for this purpose means that we cannot recommend particular types of sedative strategy during the ICU stay for improving cognitive status in critically ill patients at hospital discharge and during longer follow up.

Nonetheless, this review of the current literature suggests that the different sedation strategies applied in ICU patients (daily sedation interruption, goal-directed sedation, or even no sedation) are not associated with a worse cognitive status in ICU survivors than usual treatment.

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