A Protocol of No Sedation for Critically Ill Patients Receiving Mechanical Ventilation

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

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

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

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

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

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?

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!

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

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

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

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

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

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

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

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?

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