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Daily interruption of sedation

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https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#1
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#2
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27662565/short-term-health-related-quality-of-life-of-critically-ill-children-following-daily-sedation-interruption
#3
Nienke J Vet, Saskia N de Wildt, Carin W M Verlaat, Miriam G Mooij, Dick Tibboel, Matthijs de Hoog, Corinne M P Buysse
OBJECTIVE: Our earlier pediatric daily sedation interruption trial showed that daily sedation interruption in addition to protocolized sedation in critically ill children does not reduce duration of mechanical ventilation, length of stay, or amounts of sedative drugs administered when compared with protocolized sedation only, but undersedation was more frequent in the daily sedation interruption + protocolized sedation group. We now report the preplanned analysis comparing short-term health-related quality of life and posttraumatic stress symptoms between the two groups...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27646881/comparison-of-sedation-strategies-for-critically-ill-patients-a-protocol-for-a-systematic-review-incorporating-network-meta-analyses
#4
Brian Hutton, Lisa D Burry, Salmaan Kanji, Sangeeta Mehta, Melanie Guenette, Claudio M Martin, Dean A Fergusson, Neill K Adhikari, Ingrid Egerod, David Williamson, Sharon Straus, David Moher, E Wesley Ely, Louise Rose
BACKGROUND: Sedatives and analgesics are administered to provide sedation and manage agitation and pain in most critically ill mechanically ventilated patients. Various sedation administration strategies including protocolized sedation and daily sedation interruption are used to mitigate drug pharmacokinetic limitations and minimize oversedation, thereby shortening the duration of mechanical ventilation. At present, it is unclear which strategy is most effective, as few have been directly compared...
2016: Systematic Reviews
https://www.readbyqxmd.com/read/27472071/bedside-quantitative-electroencephalography-improves-assessment-of-consciousness-in-comatose-subarachnoid-hemorrhage-patients
#5
Jan Claassen, Angela Velazquez, Emma Meyers, Jens Witsch, M Cristina Falo, Soojin Park, Sachin Agarwal, J Michael Schmidt, Nicholas D Schiff, Jacobo D Sitt, Lionel Naccache, E Sander Connolly, Hans-Peter Frey
OBJECTIVE: Accurate behavioral assessments of consciousness carry tremendous significance in guiding management, but are extremely challenging in acutely brain-injured patients. We evaluated whether electroencephalography (EEG) and multimodality monitoring parameters may facilitate assessment of consciousness in patients with subarachnoid hemorrhage. METHODS: A retrospective analysis was performed of 83 consecutively treated adults with subarachnoid hemorrhage. All patients were initially comatose and had invasive brain monitoring placed...
October 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27428482/associations-between-ventilator-bundle-components-and-outcomes
#6
Michael Klompas, Lingling Li, Ken Kleinman, Paul M Szumita, Anthony F Massaro
IMPORTANCE: Ventilator bundles, including head-of-bed elevation, sedative infusion interruptions, spontaneous breathing trials, thromboprophylaxis, stress ulcer prophylaxis, and oral care with chlorhexidine gluconate, are ubiquitous, but the absolute and relative value of each bundle component is unclear. OBJECTIVE: To evaluate associations between individual and collective ventilator bundle components and ventilator-associated events, time to extubation, ventilator mortality, time to hospital discharge, and hospital death...
September 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27289863/nursing-factors-in-performing-daily-interruption-of-sedation-in-a-large-intensive-care-unit
#7
L Roberts, C Snelson
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27168631/antipsychotic-drug-use-and-screening-for-delirium-in-mechanically-ventilated-patients-in-canadian-intensive-care-units-an-observational-study
#8
Zoé Thiboutot, Marc M Perreault, David R Williamson, Louise Rose, Sangeeta Mehta, Melanie D Guenette, Deborah Cook, Lisa Burry
BACKGROUND: Critically ill patients frequently experience delirium, and antipsychotic drugs are often used to manage symptoms. OBJECTIVES: To describe the use of antipsychotic drugs and delirium screening tools in mechanically ventilated, critically ill adult patients in Canadian intensive care units (ICUs) and to identify factors associated with the use of antipsychotic drugs. METHODS: Pharmacists from 51 Canadian ICUs prospectively collected data on antipsychotic use and delirium screening in all patients for whom invasive mechanical ventilation was initiated during a chosen 2-week period occurring sometime in 2008 or 2009...
March 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/27145814/optimizing-sedation-in-patients-with-acute-brain-injury
#9
REVIEW
Mauro Oddo, Ilaria Alice Crippa, Sangeeta Mehta, David Menon, Jean-Francois Payen, Fabio Silvio Taccone, Giuseppe Citerio
Daily interruption of sedative therapy and limitation of deep sedation have been shown in several randomized trials to reduce the duration of mechanical ventilation and hospital length of stay, and to improve the outcome of critically ill patients. However, patients with severe acute brain injury (ABI; including subjects with coma after traumatic brain injury, ischaemic/haemorrhagic stroke, cardiac arrest, status epilepticus) were excluded from these studies. Therefore, whether the new paradigm of minimal sedation can be translated to the neuro-ICU (NICU) is unclear...
May 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27108084/analgosedation-improving-patient-outcomes-in-icu-sedation-and-pain-management
#10
Ryan Wiatrowski, Colleen Norton, David Giffen
Sedation practices in the critical care unit have been trending toward lighter sedation since the start of the new millennium, but patients continue to experience inadequate pain management and excessive sedation. This paper includes a brief examination of the problem of pain management in the ICU; trends in sedation practices, including light sedation and the daily interruption of sedation; and a literature review of analgosedation. While the analgosedation literature is relatively sparse, it offers a promising, patient-centered method for managing the triad of pain, agitation, and delirium, while reducing common complications associated with long-term ventilation...
June 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/27084181/-weaning-from-mechanical-ventilation-weaning-categories-and-weaning-concepts
#11
J Geiseler, C Kelbel
The international classification of three weaning categories (simple weaning, difficult weaning, prolonged weaning) has been modified in the German weaning guidelines: the group of prolonged weaning has been subclassified into weaning without noninvasive ventilation (NIV), weaning with NIV, if necessary with continuing NIV in the form of home mechanical ventilation, and weaning failure.Strategies to prevent prolonged weaning comprise daily interruption of sedation, daily screening of capability of spontaneous breathing by a spontaneous breathing trial (SBT) and early implementation of NIV instead of continuing invasive mechanical ventilation especially in hypercapnic patients...
April 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27080128/prediction-and-outcome-of-intensive-care-unit-acquired-paresis
#12
Oscar Peñuelas, Alfonso Muriel, Fernando Frutos-Vivar, Eddy Fan, Konstantinos Raymondos, Fernando Rios, Nicolás Nin, Arnaud W Thille, Marco González, Asisclo J Villagomez, Andrew R Davies, Bin Du, Salvatore M Maggiore, Dimitrios Matamis, Fekri Abroug, Rui P Moreno, Michael A Kuiper, Antonio Anzueto, Niall D Ferguson, Andrés Esteban
BACKGROUND: Intensive care unit-acquired paresis (ICUAP) is associated with poor outcomes. Our objective was to evaluate predictors for ICUAP and the short-term outcomes associated with this condition. METHODS: A secondary analysis of a prospective study including 4157 mechanically ventilated adults in 494 intensive care units from 39 countries. After sedative interruption, patients were screened for ICUAP daily, which was defined as the presence of symmetric and flaccid quadriparesis associated with decreased or absent deep tendon reflexes...
April 13, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27043995/implementation-of-a-ventilator-associated-pneumonia-prevention-bundle-in-a-single-picu
#13
Analía De Cristofano, Verónica Peuchot, Andrea Canepari, Victoria Franco, Augusto Perez, Pablo Eulmesekian
OBJECTIVE: Ventilator-associated pneumonia is considered the second most frequent infection in pediatric intensive care, and there is agreement on its association with higher morbidity and increased healthcare costs. The goal of this study was to apply a bundle for ventilator-associated pneumonia prevention as a process for quality improvement in the PICU of Hospital Italiano de Buenos Aires, Argentina, aiming to decrease baseline ventilator-associated pneumonia rate by 25% every 6 months over a period of 2 years...
May 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26805544/-the-progress-of-light-sedation-for-critically-ill-adult-patients-in-intensive-care-unit
#14
Shuangling Li, Dongxin Wang, Baxian Yang
The latest advance of sedation for critically ill adult patients in intensive care unit (ICU) was reviewed in order to provide certain clinical information for the ICU physicians about sedation. Guidelines, clinical research, Meta-analysis, and reviews in recent years were collected using electronic data base. Discussions included: (1) the definition of light sedation, and its effects on clinical outcome, stress, sleep and delirium; (2) light sedation strategies included: the target population, the target sedation strategy and daily sedation interruption, clinical assessment and monitoring of sedation, selection of sedative drugs, light sedation extenuation; (3) light sedation strategies and pain, agitation, delirium control bundles; (4) the problems and prospects of light sedation...
January 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/26602782/a-randomized-controlled-trial-of-daily-sedation-interruption-in-critically-ill-children
#15
RANDOMIZED CONTROLLED TRIAL
Nienke J Vet, Saskia N de Wildt, Carin W M Verlaat, Catherijne A J Knibbe, Miriam G Mooij, Job B M van Woensel, Joost van Rosmalen, Dick Tibboel, Matthijs de Hoog
PURPOSE: To compare daily sedation interruption plus protocolized sedation (DSI + PS) to protocolized sedation only (PS) in critically ill children. METHODS: In this multicenter randomized controlled trial in three pediatric intensive care units in the Netherlands, mechanically ventilated critically ill children with need for sedative drugs were included. They were randomly assigned to either DSI + PS or PS only. Children in both study arms received sedation adjusted on the basis of validated sedation scores...
February 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26489482/prevalence-risk-factors-and-outcomes-associated-with-physical-restraint-use-in-mechanically-ventilated-adults
#16
RANDOMIZED CONTROLLED TRIAL
Louise Rose, Lisa Burry, Ranjeeta Mallick, Elena Luk, Deborah Cook, Dean Fergusson, Peter Dodek, Karen Burns, John Granton, Niall Ferguson, John W Devlin, Marilyn Steinberg, Sean Keenan, Stephen Reynolds, Maged Tanios, Robert A Fowler, Michael Jacka, Kendiss Olafson, Yoanna Skrobik, Sangeeta Mehta
PURPOSE: The purpose was to describe characteristics and outcomes of restrained and nonrestrained patients enrolled in a randomized trial of protocolized sedation compared with protocolized sedation plus daily sedation interruption and to identify patient and treatment factors associated with physical restraint. METHODS: This was a post hoc secondary analysis using Cox proportional hazards modeling adjusted for center- and time-varying covariates to evaluate predictors of restraint use...
February 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26315653/protocolized-sedation-effect-on-post-icu-posttraumatic-stress-disorder-prevalence-a-systematic-review-and-network-meta-analysis
#17
REVIEW
Antonio Paulo Nassar, Fernando G Zampieri, Otavio T Ranzani, Marcelo Park
PURPOSE: Strategies aiming light sedation are associated with decreased length on mechanical ventilation. However, awake or easily arousable patients may be prone to greater prevalence of posttraumatic stress disorder (PTSD). These systematic review and meta-analysis aimed to evaluate the safety of light sedation strategies regarding the prevalence of PTSD. METHODS: We searched MEDLINE, Scopus, and Web of Science from inception to November 2014 for randomized controlled trials that evaluated light sedation strategies and addressed PTSD prevalence in the follow-up as a specific outcome...
December 2015: Journal of Critical Care
https://www.readbyqxmd.com/read/26181221/recall-of-icu-stay-in-patients-managed-with-a-sedation-protocol-or-a-sedation-protocol-with-daily-interruption
#18
RANDOMIZED CONTROLLED TRIAL
Lisa Burry, Deborah Cook, Margaret Herridge, John W Devlin, Dean Fergusson, Maureen Meade, Marilyn Steinberg, Yoanna Skrobik, Kendiss Olafson, Karen Burns, Peter Dodek, John Granton, Niall Ferguson, Michael Jacka, Maged Tanios, Robert Fowler, Steven Reynolds, Sean Keenan, Ranjeeta Mallick, Sangeeta Mehta
OBJECTIVES: To 1) describe factual, emotional, and delusional memories of ICU stay for patients enrolled in the SLEAP (Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol) trial; 2) compare characteristics of patients with and without ICU recall, and patients with and without delusional memories; and 3) determine factors associated with delusional memories 28 days after ICU discharge. DESIGN: Prospective cohort...
October 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/26056547/effect-of-sedation-on-short-term-and-long-term-outcomes-of-critically-ill-patients-with-acute-respiratory-insufficiency
#19
Xue-Zhong Xing, Yong Gao, Hai-Jun Wang, Shi-Ning Qu, Chu-Lin Huang, Hao Zhang, Hao Wang, Qing-Ling Xiao, Ke-Lin Sun
BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insufficiency who had received sedation or no sedation. METHODS: The data of 91 patients who had received mechanical ventilation in the first 24 hours between November 2008 and October 2009 were retrospectively analyzed. These patients were divided into two groups: a sedation group (n=28) and a non-sedation group (n=63). The patients were also grouped in two groups: deep sedation group and daily interruption and /or light sedation group...
2015: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25906222/daily-sedation-interruption-in-critically-ill-patients-on-mechanical-ventilation
#20
REVIEW
Chen Xiaojuan
No abstract text is available yet for this article.
May 2015: American Journal of Nursing
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