Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients

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 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 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

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

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

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

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

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 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

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

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

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

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

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