Tag: sedation
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
A Protocol of No Sedation for Critically Ill Patients Receiving Mechanical Ventilation
Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. Daily interruption of sedation has a beneficial effect, and in the general ICU of Odense University Hospital, Denmark,... read more
Letting the Patient Decide: A Case Report of Self-Administered Sedation During Mechanical Ventilation
It is common for critical care nurses to administer sedative medications to patients receiving mechanical ventilation. Although patient-controlled analgesia is frequently used in practice to promote effective self-management... read more
Evaluating the Need for Pediatric Procedural Sedation Training in Pediatric Critical Care Medicine Fellowship
Pediatric procedural sedation lacks a clearly defined training pathway. Most fellows find pediatric procedural sedation a valuable skill set. We propose that all Pediatric Critical Care Medicine fellows receive training that... read more
Medicating patients during extracorporeal membrane oxygenation
Extracorporeal membrane oxygenation (ECMO), which can support gas exchange or hemodynamics in patients with severe respiratory or cardiac failure, has demonstrated considerable evolution over the last decade [1], with a steady... read more
Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients
This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements... read more
Sedation and Neurodevelopmental Outcomes in PICU
As little as 30 minutes of exposure to anesthetic and sedative agents may adversely affect the developing brain. Safe, humane management of critically ill infants requires the use of sedative agents, often for prolonged periods.... read more
Ketamine Continuous Infusion: A Reasonable Alternative to Traditional Sedatives and Analgesics?
Propofol, dexmedetomidine, and opioids are commonly used for patients requiring continuous sedation or analgesia, such as for those receiving mechanical ventilation. Although these medications are generally safe, some may... read more
No more antipsychotics for delirium? Not so fast!
Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more
Sedation and Mobilization during Venovenous Extracorporeal Membrane Oxygenation for ARF
The majority of respondents reported targeting moderate to deep sedation following cannulation, with the use of sedative and opioid infusions. There is considerable variability surrounding early physical therapy and mobilization... read more
Early Mobilization in the PICU
Mobilization of critically ill children, many with central lines, endotracheal tubes, and other life-saving devices, is associated with potential risks and complications. Hence, concerns about safety often guide staff perceptions... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Effect of Dexmedetomidine on Mortality and Ventilation in Sepsis Patients
Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. This randomized clinical trial compares... read more
Alcohol Withdrawal: One Order to Sedate Them All
This is a retrospective cohort study describing 86 admissions to the ICU for alcohol withdrawal between 2011-2015. 86% were treated with benzodiazepines before ICU admission, usually on the general ward. The average dose... read more
Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support
Among ICU patients receiving acute ventilatory support for respiratory failure, patient-directed music (PDM) resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM... read more
Finding Out What Matters to Our Patients
Do you spend time finding out what the "why" is for your patient? Have you considered it’s not what is the matter with the patient but what matters to the patient? What the patient thinks their purpose is? Or at the very... read more
SOS Asynchronies: Do We Need Help?
Synchrony between the patient and the ventilator is defined as the appropriate interaction between the two, where the ventilator recognizes patient’s effort and provides support for breathing at the right time—that is,... read more
How You Can Protect Your Parent From Delirium
Unlike dementia, which is constant and gets progressively worse, delirium tends to come and go, fluctuating even in the course of a day. The symptoms are transitory, yet for people who develop delirium, it can be the start... read more
