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Ketamine And intensive care AND sedation

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https://www.readbyqxmd.com/read/29721645/midazolam-increases-preload-dependency-during-endotoxic-shock-in-rabbits-by-affecting-venous-vascular-tone
#1
Jianxiao Chen, Tao Yu, Federico Longhini, Xiwen Zhang, Songqiao Liu, Ling Liu, Yi Yang, Haibo Qiu
BACKGROUND: Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The aim of this study is to investigate the effects of midazolam on preload dependency in an endotoxic shock model by evaluating systemic vascular tone and cardiac function. METHODS: Eighteen rabbits were randomly divided into three groups: Control group, MID1 group and MID2 group...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#2
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29607710/comparison-of-ketamine-versus-nonketamine-based-sedation-on-delirium-and-coma-in-the-intensive-care-unit
#3
Vanessa Shurtleff, John J Radosevich, Asad E Patanwala
BACKGROUND: At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE: The objective of this study was to evaluate the number of days alive without delirium or coma in mechanically ventilated patients in the intensive care unit receiving analgosedation infusions with ketamine versus without ketamine...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#4
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29335074/trends-in-narcotics-and-sedative-use-during-mechanical-ventilation-of-preterm-infants-in-canadian-neonatal-intensive-care-units
#5
(no author information available yet)
OBJECTIVE: Mechanical ventilation (MV) in preterm infants (PTI) causes discomfort. Whether it causes pain is controversial. Meta analysis reviews of published work on PTI during MV have shown no clinically significant impact of opioids on pain scales, and hence not recommended for routine use in neonatal intensive care units (NICUs). Similarly regular use of sedative midazolam is also not recommended. Therefore we hypothesized a downward trend in narcotics and sedatives used in MV of PTI in NICUs...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29186909/ketamine-a-clinically-used-anesthetic-inhibits-vascular-smooth-muscle-cell-proliferation-via-pp2a-activated-pi3k-akt-erk-inhibition
#6
Yi Chang, Jiun-Yi Li, Thanasekaran Jayakumar, Shou-Huang Hung, Wei-Cheng Lee, Manjunath Manubolu, Joen-Rong Sheu, Ming-Jen Hsu
Abnormal proliferation of vascular smooth muscle cells (VSMCs) gives rise to major pathological processes involved in the development of cardiovascular diseases. The use of anti-proliferative agents for VSMCs offers potential for the treatment of vascular disorders. Intravenous anesthetics are firmly established to have direct effects on VSMCs, resulting in modulation of blood pressure. Ketamine has been used for many years in the intensive care unit (ICU) for sedation, and has recently been considered for adjunctive therapy...
November 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29108735/emergency-department-patient-burden-from-an-electronic-dance-music-festival
#7
Neeraj Chhabra, Renee P Gimbar, Lisa M Walla, Trevonne M Thompson
BACKGROUND: Electronic dance music (EDM) festivals are increasingly common and psychoactive substance use is prevalent. Although prehospital care can obviate the transfer of many attendees to health care facilities (HCFs), little is known regarding the emergency department (ED) burden of patients presenting from EDM festivals. OBJECTIVES: This study describes the patient volume, length of stay (LOS), and presenting complaints of patients from a 3-day EDM festival in close proximity to an area ED...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29064259/the-cardiovascular-implications-of-sedatives-in-the-cardiac-intensive-care-unit
#8
Sammy Zakaria, Helaine J Kwong, Jonathan E Sevransky, Marlene S Williams, Nisha Chandra-Strobos
Patients admitted to the cardiac intensive care unit frequently develop multi-organ system dysfunction associated with their cardiac disease. In many cases, invasive mechanical ventilation is required, which often necessitates sedation for patient-ventilator synchrony, reduction of work of breathing, and patient comfort. In this paper, we describe the use of common sedatives available in the endotracheally intubated critically ill patient and emphasize the clinical and cardiovascular effects. We review γ-aminobutyric acid agonists such as etomidate, benzodiazepines, and propofol, the centrally acting α2 -agonist dexmedetomidine, and the N-methyl-D-aspartate receptor antagonist ketamine...
February 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29043601/pupillary-reflex-dilation-in-response-to-incremental-nociceptive-stimuli-in-patients-receiving-intravenous-ketamine
#9
Nada Sabourdin, Thomas Giral, Risa Wolk, Nicolas Louvet, Isabelle Constant
Pupillometry is a non-invasive monitoring technique, which allows dynamic pupillary diameter measurement by an infrared camera. Pupillary diameter increases in response to nociceptive stimuli. In patients anesthetized with propofol or volatile agents, the magnitude of this pupillary dilation is related to the intensity of the stimulus. Pupillary response to nociceptive stimuli has never been studied under ketamine anesthesia. Our objective was to describe pupillary reflex dilation after calibrated tetanic stimulations in patients receiving intravenous ketamine...
October 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29030928/pharmacokinetics-of-s-ketamine-during-prolonged-sedation-at-the-pediatric-intensive-care-unit
#10
Robert B Flint, Carole N M Brouwer, Anne S C Kränzlin, Loraine Lie-A-Huen, Albert P Bos, Ron A A Mathôt
BACKGROUND: S-ketamine is the S(+)-enantiomer of the racemic mixture ketamine, an anesthetic drug providing both sedation and analgesia. In clinical practice, significant interpatient variability in drug effect of S-ketamine is observed during long-term sedation. AIMS: The aim of this study was to evaluate the pharmacokinetic variability of S-ketamine in children aged 0-18 years during long-term sedation. Twenty-five children (median age: 0.42 years, range: 0...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28461010/effects-of-ketamine-dexmedetomidine-and-propofol-anesthesia-on-emotional-memory-consolidation-in-rats-consequences-for-the-development-of-post-traumatic-stress-disorder
#11
Maria Morena, Andrea Berardi, Andrea Peloso, Daniela Valeri, Maura Palmery, Viviana Trezza, Gustav Schelling, Patrizia Campolongo
Intensive Care Unit (ICU) or emergency care patients, exposed to traumatic events, are at increased risk for Post-Traumatic Stress Disorder (PTSD) development. Commonly used sedative/anesthetic agents can interfere with the mechanisms of memory formation, exacerbating or attenuating the memory for the traumatic event, and subsequently promote or reduce the risk of PTSD development. Here, we evaluated the effects of ketamine, dexmedetomidine and propofol on fear memory consolidation and subsequent cognitive and emotional alterations related to traumatic stress exposure...
June 30, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28393778/safety-and-efficacy-of-ketamine-dexmedetomidine-versus-ketamine-propofol-combinations-for-sedation-in-patients-after-coronary-artery-bypass-graft-surgery
#12
COMPARATIVE STUDY
Mona Mohamed Mogahd, Mohammed Shafik Mahran, Ghada Foad Elbaradi
BACKGROUND AND AIMS: Prolonged mechanical ventilation after cardiac surgery is associated with serious complications that increase morbidity and mortality. The present study was designed to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for sedation and analgesia in patients after coronary artery bypass graft (CABG) surgery as regards hemodynamics, total fentanyl dose, time of weaning from mechanical ventilation, time of extubation, and any adverse outcome...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28182021/procedural-moderate-sedation-with-ketamine-in-pediatric-critical-care-unit
#13
Tarek R Hazwani, Hala Al-Alem
OBJECTIVE: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. SETTINGS AND DESIGN: A retrospective study was conducted in the PICU. MATERIALS AND METHODS: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28176512/respiratory-adverse-events-during-upper-digestive-endoscopies-in-children-under-ketamine-sedation
#14
Jose C Flores-González, Alfonso M Lechuga Sancho, Mónica Saldaña Valderas, Gema Jimenez Gomez, Maria D Cruzado Garcia, Cristina Perez Aragon, Jose A Blanca Garcia
BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28173733/practice-of-intubation-of-the-critically-ill-at-mayo-clinic
#15
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVE: To describe the practice of intubation of the critically ill at a single academic institution, Mayo Clinic's campus in Rochester, Minnesota, and to report the incidence of immediate postintubation complications. PATIENTS AND METHODS: Critically ill adult (≥18 years) patients admitted to a medical-surgical intensive care unit from January 1, 2013, to December 31, 2014, who required endotracheal intubation included. RESULTS: The final cohort included 420 patients...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27924651/caffeine-combined-with-sedative-anesthetic-drugs-triggers-widespread-neuroapoptosis-in-a-mouse-model-of-prematurity
#16
Omar Hoseá Cabrera, Shawn David O'Connor, Brant Stephen Swiney, Patricia Salinas-Contreras, Francesca Maria Manzella, George Townsend Taylor, Kevin Kiyoshi Noguchi
OBJECTIVES: Caffeine (CAF) and sedative/anesthetic drugs (SADs) are often coadministered to premature infants in the neonatal intensive care unit (NICU). While SAD neurotoxicity in the developing brain is well established, it is not fully clear whether CAF interacts with SADs and whether this interaction is detrimental. Using a mouse model of prematurity, we hypothesized that CAF would increase apoptotic neurotoxicity when coadministered with SADs. METHODS: Postnatal day 3 mice were treated with vehicle or 80 mg/kg CAF prior to challenge with 6 mg/kg midazolam, 40 mg/kg ketamine, or 40 μg/kg fentanyl...
November 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27850500/862-adjunctive-ketamine-for-sedation-in-the-surgical-intensive-care-unit
#17
Samantha Moore, Vivek Moitra, Paul Weyker, Mona Patel
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27695362/reduction-of-central-neuropathic-pain-with-ketamine-infusion-in-a-patient-with-ehlers-danlos-syndrome-a-case-report
#18
Tony Chung Tung Lo, Stephen Tung Yeung, Sujin Lee, Kira Skavinski, Solomon Liao
OBJECTIVE: Ehlers-Danlos syndrome frequently causes acute and chronic pain because of joint subluxations and dislocations secondary to hypermobility. Current treatments for pain related to Ehlers-Danlos syndrome and central pain syndrome are inadequate. This case report discusses the therapeutic use of ketamine intravenous infusion as an alternative. CASE REPORT: A 27-year-old Caucasian female with a history of Ehlers-Danlos syndrome and spinal cord ischemic myelopathy resulting in central pain syndrome, presented with severe generalized body pain refractory to multiple pharmacological interventions...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27610299/successful-management-of-dexmedetomidine-for-postoperative-intensive-care-sedation-in-a-patient-with-anti-nmda-receptor-encephalitis-a-case-report-and-animal-experiment
#19
Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
BACKGROUND: Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis. FINDINGS: (1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27517801/prehospital-ketamine-is-a-safe-and-effective-treatment-for-excited-delirium-in-a-community-hospital-based-ems-system
#20
Thomas R Scaggs, David M Glass, Megan Gleason Hutchcraft, William B Weir
Excited delirium syndrome (ExDS) is defined by marked agitation and confusion with sympathomimetic surge and incessant physical struggle, despite futility, which may lead to profound pathophysiologic changes and sudden death. Severe metabolic derangements, including lactic acidosis, rhabdomyolysis, and hyperthermia, occur. The pathophysiology of excited delirium is a subject of ongoing basic science and clinical research. Positive associations with ExDS include male gender, mental health disorders, and substance abuse (especially sympathomimetics)...
October 2016: Prehospital and Disaster Medicine
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