Tag: sedation
4D Trial Unlocks Calm: Dexmedetomidine Eases Hyperactive Delirium in Non-Intubated ICU Patients
The 4D randomized clinical trial, a multicenter, double-blind, placebo-controlled study conducted across nine ICUs, investigated the effectiveness of continuous intravenous dexmedetomidine infusion versus placebo in non-intubated... read more
Less Sedation, Shorter Stays: The Benefit of Analgesia-Based Protocols
A retrospective study conducted in a 24-bed medical Intensive Care Unit (ICU) compared patient outcomes before and after implementing a new analgesia-based sedation protocol. The research included 79 patients managed... read more
Moderate and Deep Sedation in Clinical Practice
Millions of procedures requiring sedation are performed each year, covering a large array of medical specialties in both inpatient and outpatient settings. This tremendous growth has led to sedation being administered by... read more
Optimizing Sedation & Analgesia in the ICU, An Issue of Critical Care Clinics, E-Book (The Clinics: Internal Medicine)
In this issue of Critical Care Clinics, guest editors Drs. Yahya Shehabi, Joanna L. Stollings, and Timothy D. Gerard bring their considerable expertise to the topic of Optimizing Sedation and Analgesia in the ICU. Top... read more
Handbook of Evidence-Based Critical Care
This updated and revised edition of the classic bedside pocket reference remains the gold standard in critical care medicine. The new edition maintains Dr. Marik's trademark humor and engaging writing style, while adding... read more
Kidney Caution: The Polyuria Peril of Prolonged Sevoflurane in the ICU
This observational study investigated the renal impact of prolonged sevoflurane sedation in Intensive Care Unit (ICU) patients, focusing specifically on the incidence of polyuria (excessive urine output, defined as > 3000... read more
Dexmedetomidine’s ICU Advantage: Faster Exit, Longer Stay?
This updated meta-analysis compared the outcomes of using dexmedetomidine versus other standard sedatives in mechanically ventilated patients with sepsis. Objective: To synthesize recent evidence (2020–2025) from Randomized... read more
Opioid Use in Critical Care: A Practical Guide
This book provides a concise yet comprehensive overview on the use of opioids in the ICU, offering practical, real-world recommendations on opioid utilization and alternative therapies. The text explains the physiology... read more
Bedside Procedures in the ICU
This handbook is a guide to best practice in interventions commonly encountered in the ICU. It is clinically orientated providing step-by-step explanations and illustrations of most invasive procedures, check lists to make... read more
The Hidden Danger of Insufficient Sedation in ARDS
This prospective observational study highlights a critical issue in the Intensive Care Unit (ICU): a substantial number of patients with Acute Respiratory Distress Syndrome (ARDS) receiving continuous neuromuscular blockade... read more
VIS to Win: Predicting Mortality After Infective Endocarditis Surgery
This study explored the predictive power of the Vasoactive-Inotropic Score (VIS) in patients who underwent valve replacement surgery for infective endocarditis (IE). The key finding is that the VIS is a strong and superior... read more
Remimazolam Triumphs Over Propofol for Safer ICU Sedation During Bronchoscopy
This randomized controlled trial compared remimazolam to propofol for moderate sedation during fiberoptic bronchoscopy (FB) in critically ill patients in the Surgical Intensive Care Unit (SICU) who had pre-existing liver... read more
Melatonin for Delirium Prevention: The Sleep Hormone Doesn’t Pass the ICU Test
Despite its frequent occurrence and association with increased mortality in critically ill patients, delirium prevention remains challenging. A recent meta-analysis sought to resolve conflicting results from randomized controlled... read more
Delirium vs. Encephalopathy: Unifying the Approach to Brain Dysfunction
Current clinical practice and research are limited by the separate, or dichotomized, use of the terms "encephalopathy" and "delirium." This separation hinders a unified approach to understanding acute brain dysfunction. Encephalopathy... read more
VAEs are Real: Advanced Modeling Confirms Ventilator Events Drive Worse Outcomes
The study by Nakahashi et al. significantly advances our understanding of Ventilator-Associated Events (VAEs) by using advanced causal modeling. Their findings firmly establish that VAEs are clinically significant events... read more
Sedation and Analgesia for the Pediatric Intensivist: A Clinical Guide
This book provides a comprehensive overview on sedation and analgesia for the pediatric intensivist. Divided into two primary sections, the text presents a framework on how to care for patients who need sedation, analgesia,... read more
Low-Dose Esketamine and Remimazolam for Pediatric Bronchoscopy
The proposed combination of low-dose esketamine and remimazolam represents a paradigm shift in pediatric bronchoscopy anesthesia, theoretically harmonizing efficacy and safety through pharmacodynamic synergy. By capitalizing... read more
Managing Opioid Requirements for Buprenorphine/Naloxone Patients on Ventilators
In a study of 176 mechanically ventilated patients, researchers found that patients who were taking buprenorphine/naloxone before they were admitted to the hospital had similar opioid requirements during ventilation as those... read more
Reduce Delirium in Critically Ill Patients Using Depth of Sedation Monitors
Delirium impacts up to 80% of patients in the intensive care unit (ICU). Current clinical sedation scales depend on subjective measurements, which are unreliable. We hypothesize processed EEG (pEEG) may be effective at monitoring... read more
Impact of Low-Dose Ketamine Infusion on Intracranial Pressure and Hemodynamics in Septic Shock Patients
Adult patients with septic shock, on hemodynamic support, had high-to-normal intracranial pressure (ICP). Low-dose continuous ketamine infusion as an adjunct sedative appeared to have favorable outcomes concerning ICP and... read more
Altered Lower Brainstem Neurophysiological Response Is Associated with Mortality In Deeply Sedated Critically Ill Patients
Absent cough reflex is associated with mortality in intensive care unit (ICU) patients requiring deep sedation, suggesting that lower brainstem dysfunction contributes to adverse outcomes. We conducted a multicenter observational... read more
Impact of Esketamine vs. Remifentanil on Hemodynamics and Outcomes in Mechanically Ventilated Septic Shock
This single-center, prospective, randomized, controlled pilot study compared the hemodynamic effects and prognosis of esketamine versus remifentanil, both used in combination with propofol, for sedation and analgesia in patients... read more
