Severe ICU-Acquired Hypernatremia: Prevalence, Risk Factors, Trajectory, Management, and Outcome

Severe hypernatremia occurred in the setting of inability to drink, near-absent measurement of urinary free water losses, diuretic therapy, fever, renal impairment, and near-absent or limited or delayed water administration.... read more

Music Therapy Intervention to Treat Sedation-Related Delirium in Critical Care

Music Therapy Intervention to Treat Sedation-Related Delirium in Critical Care

Sedation is an essential component of treatment for some patients admitted to the intensive care unit, but it carries a risk of sedation-related delirium. Sedation-related delirium is associated with higher mortality and... read more

The Reemergence of Ketamine for Treatment in Critically Ill Adults

The Reemergence of Ketamine for Treatment in Critically Ill Adults

Ketamine has suggested potential benefit in several disease states impacting critically ill patients including pain, alcohol withdrawal syndrome, status epilepticus, and acute agitation. Further supporting evidence is needed... read more

Post-acute Neurological Consequences of COVID-19

Post-acute Neurological Consequences of COVID-19

COVID-19 and its neurological consequences particularly burden marginalized communities, and so can only be effectively treated by advancing health equity. Our world has witnessed over 275 million confirmed cases of COVID-19... read more

Effect of High-Dose Baclofen on Agitation-Related Events Among Patients With Unhealthy Alcohol Use Receiving Mechanical Ventilation

Effect of High-Dose Baclofen on Agitation-Related Events Among Patients With Unhealthy Alcohol Use Receiving Mechanical Ventilation

Among patients with unhealthy alcohol use receiving mechanical ventilation, treatment with high-dose baclofen, compared with placebo, resulted in a statistically significant reduction in agitation-related events. The primary... read more

Impact of Natural Light Exposure on Delirium Burden in Adult Patients Receiving Invasive Mechanical Ventilation in the ICU

Impact of Natural Light Exposure on Delirium Burden in Adult Patients Receiving Invasive Mechanical Ventilation in the ICU

Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was... read more

Sedation and Analgesia in the ICU

Sedation and Analgesia in the ICU

Sedation and analgesia have high importance in patient-centered care. Patients in the ICU are seriously ill and often suffer from anxiety, agitation, and pain. There is sometimes a need to use deep and prolonged sedation,... read more

Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients

Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients

The majority of patients in our study demonstrated signs that may be indicative of dexmedetomidine withdrawal. Peak and cumulative daily dexmedetomidine dose, rather than duration of therapy, may be associated with a higher... read more

Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?

Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?

Generally, the bundle was deemed acceptable and deliverable. However, like any complex intervention, component adaptations will be required depending on resources available to the ICU; in particular, involvement of pharmacists... read more

Ramelteon for Prevention of Postoperative Delirium

Ramelteon for Prevention of Postoperative Delirium

Ramelteon 8 mg did not prevent postoperative delirium in patients admitted for elective cardiac surgery. Incident delirium was measured twice daily using the Confusion Assessment Method-ICU. The safety outcome was... read more

Abdominal Compartment Syndrome

Abdominal Compartment Syndrome

Abdominal compartment syndrome (ACS) is defined by sustained intra-abdominal pressure (IAP) > 20 mm Hg with associated organ injury. The condition was first described in 1863, but not significantly discussed until the 1990s.... read more

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more

Hypernatremia & Dehydration in the ICU

Hypernatremia & Dehydration in the ICU

Hypernatremia is very common in the ICU. It often develops during ICU admission due to inadequate free water administration. Hypernatremia is not benign, it causes profound thirst, particularly among intubated patients, this... read more

Excited Delirium: Acute Management in the ED Setting

Excited Delirium: Acute Management in the ED Setting

Excited delirium syndrome is a common yet poorly characterized ED presentation with a wide differential diagnosis. Patients are often identified initially by law enforcement, but attempts to control individuals experiencing... read more

Sedation in ICU patients – Need for Standardized Protocols

Sedation in ICU patients – Need for Standardized Protocols

A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes.... read more

The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU

The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU

The CAM-ICU-7 delirium severity scale is a valid, reliable, and practical delirium severity measure among ICU patients that can be easily calculated and is associated with meaningful clinical outcomes. This practical tool... read more

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more