Tag: sedation
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
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
Mechanical Ventilation Sedation Necessary for Comfort According to Nurses
Nurses' attitudes toward sedating patients receiving mechanical ventilation have shifted in the past decade, with fewer nurses now believing that all patients should be sedated. However, more than half of nurses still agree... read more
Prophylactic Haloperidol Effects on Long-term Quality of Life in Critically Ill Patients at High Risk for Delirium
Prophylactic haloperidol use does not affect long-term quality of life in critically ill patients at high risk for delirium. Several factors, including the modifiable factor number of sedation-induced coma days, are associated... read more
Sedation Practices of Neonates Receiving ECMO
Neonatal sedation practices during extracorporeal membrane oxygenation (ECMO) are not well described and no universal guidelines exist. Current literature describes types of medications used in adult and pediatric ECMO... read more
Extubating Ventilated Patients on Vasoactive Infusions is Safe
In a large single centre study, 21% of intubated patients who received infusions of vasoactive infusions while mechanically ventilated were extubated for the first time while still receiving them. Coincident with their earlier... read more
Inter-Rater Reliability Between PICU Nurses Performing a Modification to the Glasgow Coma Scale
The objective of this study was to estimate the inter-rater reliability of critical care nurses performing a pediatric modification of the Glasgow Coma Scale in a contemporary pediatric intensive care unit (PICU). All... read more
Droperidol Use in the Emergency Department – What’s Old is New Again
Earlier this year American Reagent announced the re-introduction of droperidol back into the US market. This is bringing an old favorite back to many EM docs and a novel tool for new residents and attendings who have never... read more
Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial
The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more
Sedatives in Neurocritical Care
Extrapolating the findings from studies in the general ICU population suggests to reserve deep continuous sedation in the neuro-ICU for specific indications. Although an improved understanding of cerebral physiological changes... read more
Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy
Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more
Pharmacotherapy in Neurointensive Care
Neurointensive care medicine has experienced great advancements and developments of neuromonitoring techniques, allowing a better comprehension of acute brain injury early phase pathological mechanisms and an overall improvement... read more
Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval
Acute behavioural disturbance(ABD), also known as Excited Delirium Syndrome, is a medical emergency with reported mortality of 8-10%. The management of ABD usually involves a judicious combination of de-escalation techniques,... read more
Sedation in the ICU – Good Past – Better Future?
The concepts for good sedation include defining the range of sedation, the need for agents with rapid response that can be easily and rapidly varied in restless and confused patients, various modes of ventilation, continuous... read more
Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation
Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role... read more
Sedation Practice in ECMO-Treated Patients with ARDS
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more
Sedation in ICU patients – Need for Standardized Protocols
A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes.... read more
Tidal Volume Strategies for those without ARDS
This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more
Applied Physiology at the Bedside: Volumetric Capnography
Volumetric capnography is the graphical representation of the partial pressure of carbon dioxide (CO2) versus exhaled volume. This measurement is made noninvasively at every breath by a combination of flow and CO2 sensors,... read more
ICU Physiology in 1000 Words: The Mean Systemic Filling Pressure
Consider sitting deep within the hull of this cruise ship, ignorant to the outside. A leak is sprung and ocean begins to rush in. Thinking quickly you activate the bilge pump which, appropriately, ejects the ocean outside... read more
A Prospective Investigation of Interleukin-8 Levels in Pediatric ARF and ARDS
The association of plasma interleukin-8 (IL-8), or IL-8 genetic variants, with pediatric acute respiratory distress syndrome (PARDS) in children with acute respiratory failure (ARF) at risk for PARDS has not been examined.... read more
Low-dose Nocturnal Dexmedetomidine Prevents ICU Delirium
Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring... read more
