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

ICU Doctors Already Know How to Get COVID-19 Patients Off Ventilators Faster

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

An Interview With an Italian Intensivist on the COVID Experience in Italy

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

Best Practice Advisories Improve Sedation Protocol Compliance in the ICU

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

When Exercise Comes to the Hospital’s ICUs

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

Impact of Paralytic Agent on Postintubation Sedation

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

Changes in Anesthetic and Postoperative Sedation-Analgesia Practice Associated With Early Extubation Following Infant Cardiac Surgery

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

Sedation and Analgesia in the ICU

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

The Association Between Ventilator Dyssynchrony, Delivered Tidal Volume, and Sedation Using a Novel Automated Ventilator Dyssynchrony Detection Algorithm

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

Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients

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

Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium

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

Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support

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

How To Prevent Brain-Sapping Delirium In The ICU

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

Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children

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

Surviving Critical Illness: What Is Next?

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

Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients

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

Ramelteon for Prevention of Postoperative Delirium

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

Automated vs. Non-automated Weaning for Reducing Mechanical Ventilation Duration for Critically Ill

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

Sedation is Necessary to Minimize Patients’ Discomfort During Mechanical Ventilation

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

Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes

Implementation Challenges in the ICU: The Why, Who and How of Daily Interruption of Sedation

Despite apparent consensus, lack of shared understanding of the rationale for an intervention may lead to divergent practice patterns and failure to implement standardized, evidence-based practice. There was wide consensus... read more

Implementation Challenges in the ICU: The Why, Who and How of Daily Interruption of Sedation

Sedation and Analgesia Impact On Long-term Cognitive Dysfunction in Critical Care Survivors

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... read more

Sedation and Analgesia Impact On Long-term Cognitive Dysfunction in Critical Care Survivors