Tag: sedation
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
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
