Tag: sedation
Sedation with Midazolam After Cardiac Surgery in Children with and without Down Syndrome
The majority of children with and without Down syndrome required additional sedation after cardiac surgery. This pharmacokinetic and pharmacodynamic analysis does not provide evidence for different dosing of midazolam in... read more
Replacement of Fentanyl Infusion by Enteral Methadone Decreases the Weaning Time From Mechanical Ventilation
The introduction of enteral methadone during weaning from sedation and analgesia in mechanically ventilated patients resulted in a decrease in the weaning time from mechanical ventilation (MV). A double-blind randomized... read more
A Bad Sedation Package Leaves your Patient Trapped in a Nightmare
Pushing some ativan followed by vecuronium is no longer an acceptable strategy to manage post-intubation sedation. A good analgesia and sedation package is essential if you care about your patient's comfort and well-being.... read more
Conversion From Continuous Infusion Fentanyl to Continuous Infusion Hydromorphone in the Pediatric ICU
A median 14% fentanyl dose reduction was noted when transitioning to hydromorphone. Further exploration is needed to determine if opioid rotations with hydromorphone can reduce opioid/sedative exposure. A total of 36 children... read more
Balanced Opioid-free Anesthesia with Dexmedetomidine vs. Balanced Anesthesia with Remifentanil for Noncardiac Surgery
This trial refuted the hypothesis that balanced opioid-free anesthesia with dexmedetomidine, compared with remifentanil, would result in fewer postoperative opioid-related adverse events. Conversely, it did result in a greater... read more
Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial
In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely,... read more
The Effect of Early Sedation With Dexmedetomidine on Body Temperature in Critically Ill Patients
Previous case series reported an association between dexmedetomidine use and hyperthermia. Temperature data have not been systematically reported in previous randomized controlled trials evaluating dexmedetomidine. Our... read more
Analysis of Fentanyl Pharmacokinetics and Tolerance in Critically-Ill Children
Different weight-based fentanyl dosing rates may be required for infants and children of different ages to achieve similar plasma concentrations. Using SBS scores may guide the dosing titration of fentanyl that resulted in... read more
Delirium Incidence, Duration, and Severity in Critically Ill Patients with COVID-19
Delirium without coma occurred in 29.1% of patients admitted to the ICU. Delirium persisted for a median of 5 days and was severe. Mechanical ventilation was significantly associated with odds of delirium even after adjustment... read more
Perspectives of Ketamine Use in COVID-19 Patients
Hospitalized coronavirus disease 2019 (COVID-19)-infected patients suffer from both physical impairments and mental stress. Respiratory insufficiency and cardiovascular disturbances require most of the intensive care... read more
Delirium Prevalence and Risk Factors for Critically Ill COVID-19 Patients
Acute brain dysfunction was highly prevalent and prolonged in critically ill patients with COVID-19. Benzodiazepine use and lack of family visitation were identified as modifiable risk factors for delirium, and thus these... read more
Myorelaxants in ARDS patients
Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory... read more
Efficacy and Safety of a Paired Sedation and Ventilator Weaning
The purpose of this study is to determine the impact of a new RN/RRT (Registered Nurse/Registered Respiratory Therapist) directed 2-step protocol to wean patients off of a ventilator. This protocol involves daily attempts... read more
Efficacy and Safety of a Paired Sedation and Ventilator Weaning Protocol in ICU
Approaches to removal of sedation and mechanical ventilation for critically ill patients vary widely. Our aim was to assess a protocol that paired spontaneous awakening trials (SATs)—ie, daily interruption of sedatives—with... read more
Automated vs. Conventional Ventilation in the ICU
Automated ventilation (AV) appears to reduce the incidence and severity of blood oxygen desaturation during daily nursing procedures (DNPs) in comparison to Conventional Ventilation (CV). Of the 265 included patients,... read more
Comparing Procedural Amnesia and Respiratory Depression vs. MS and DS with Propofol
Targeting moderate sedation (MS) or deep sedation (DS) did not reliably result in the intended sedation level. Targeting MS, however, resulted in a lower rate of total AREs and fewer patients had multiple AREs with no difference... read more
Working in ICU is like Flying a Plane: The Secret World of Intensive Care
Stepping on to the ICU during this period was like entering another world. In a way intensive care has always seemed like a place removed from life outside said Mike Brunner, an intensive care doctor at Northwick Park hospital... read more
Dexmedetomidine for Prolonged Sedation in the PICU
High-quality data on dexmedetomidine use for prolonged sedation and a consensus on correct dosing and weaning protocols in children are currently missing. Infusion of dexmedetomidine can be considered relatively safe in pediatrics... read more
Procedural Sedation in the COVID-19 Era
Resuming procedural sedation services for elective procedures during the COVID-19 pandemic requires unique considerations to ensure safety for patients and providers. Guidelines for resuming these procedures, including timing,... read more
Transpulmonary Thermodilution Detects Rapid and Reversible Increases in Lung Water Induced by PEEP in ARDS
In ARDS patients, changing the positive end-expiratory pressure (PEEP) level induced parallel, small and reversible changes in EVLW. These changes were not due to an artefact of the TPTD technique and were likely due to the... read more
Pharmacokinetics and Sedative Effects of Intranasal Dexmedetomidine in Ambulatory Pediatric Patients
These results demonstrate that intranasally (IN) dexmedetomidine is relatively rapidly absorbed and causes significant sedation in pediatric patients. Pharmacokinetics of IN dexmedetomidine in pediatric patients show quite... read more
