Tag: sedation
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
ICU Doctors Already Know How to Get COVID-19 Patients Off Ventilators Faster
The coronavirus pandemic is instilling chaos that is shaking the world. When intensive care units are running out of ventilators and essential medications, and some 95,000 people die in a matter of a few months, society panics... read more
An Interview With an Italian Intensivist on the COVID Experience in Italy
The current COVID-19 crisis has a huge human impact. Clearly cardiovascular issues have a central role in management and, unfortunately, in adverse outcomes. We are continually struggling to understand risks and management... read more
Best Practice Advisories Improve Sedation Protocol Compliance in the ICU
Best practice advisories can be effectively used in ICUs to improve sedation protocol compliance and may mitigate potential propofol-related hazardous conditions. Best practice advisories should undergo continuous quality... read more
When Exercise Comes to the Hospital’s ICUs
Even short hospital ICU stays can cause lasting problems for patients. Can early mobility and exercise help? Apna Kudchadkar still remembers the morning in 2010 that shaped the trajectory of her scientific research. She... read more
Impact of Paralytic Agent on Postintubation Sedation
The aim of this study was to evaluate the difference in the time to postintubation sedation between patients receiving etomidate and either succinylcholine or rocuronium in the prehospital setting. This study suggests... read more
Changes in Anesthetic and Postoperative Sedation-Analgesia Practice Associated With Early Extubation Following Infant Cardiac Surgery
The implementation of an early extubation clinical practice guideline resulted in a reduction in the dose of opioids and benzodiazepines without a change in volatile anesthetic agent used in the operating room. Intraoperative... read more
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
The Association Between Ventilator Dyssynchrony, Delivered Tidal Volume, and Sedation Using a Novel Automated Ventilator Dyssynchrony Detection Algorithm
We developed a computerized algorithm that accurately detects three types of ventilator dyssynchrony. Double-triggered and flow-limited breaths are associated with the frequent delivery of tidal volumes of greater than... read more
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
Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium
In the primary analysis, limiting the level of sedation provided no significant benefit in reducing incident delirium. However, in a pre-specified subgroup analysis, lighter sedation levels benefitted reducing postoperative... read more
Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support
Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention... read more
How To Prevent Brain-Sapping Delirium In The ICU
After an overwhelming infection sent O'Burke into five-organ failure, he also developed ICU delirium, perhaps related to heavy sedation. An ICU protocol developed at Vanderbilt University Medical Center found that getting... read more
Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children
The results highlight the heterogeneity in sedation practices among intensivists who care for critically ill children as well as a paucity of sleep promotion and delirium screening in PICUs worldwide. The survey was completed... read more
Surviving Critical Illness: What Is Next?
This consensus-based framework for PT after hospital discharge aims to improve long-term outcomes for survivors of critical illness. Physical therapists should seek close collaboration with the multidisciplinary team... read more
Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients
Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status. 72 patients were included in the initial group and 72... read more
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
Automated vs. Non-automated Weaning for Reducing Mechanical Ventilation Duration for Critically Ill
Automated systems may result in clinically meaningful reduced durations of weaning, ventilation and ICU stay. Overall, these systems appear to be safe and can be considered a reasonable approach in the management of ventilator... read more
Sedation is Necessary to Minimize Patients’ Discomfort During Mechanical Ventilation
More than half of critical care nurses believe sedation is needed to minimize discomfort and distress among patients receiving mechanical ventilation, according to survey results published recently in the American Journal... read more
Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes
Diaphragm atrophy developing during mechanical ventilation strongly impacts clinical outcomes. Targeting an inspiratory effort level similar to that of healthy subjects at rest might accelerate liberation from ventilation.... read more
