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Noninvasive pressure sedation

M Toscano, G Spadetta, P Pulitano, M Rocco, V Di Piero, O Mecarelli, E Vicenzini
Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD). Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD...
2017: BioMed Research International
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
Jeff Miller, Lili Ding, James Spaeth, Jennifer Lam, Joanna Paquin, Erica Lin, Allison Divanovic, Bi Lian Li, Shankar Baskar, Andreas W Loepke
BACKGROUND: Many children with Trisomy 21 have neurologic or behavioral problems that make it difficult for them to remain still during noninvasive imaging studies, such as transthoracic echocardiograms (TTEcho). Recently, intranasal dexmedetomidine sedation has been introduced for this purpose. However, dexmedetomidine has been associated with bradycardia. Children with Trisomy 21 have been reported to have a higher risk of bradycardia and airway obstruction with sedation or anesthesia compared to children without Trisomy 21...
February 8, 2017: Paediatric Anaesthesia
Brian E Driver, Robert F Reardon
Some patients are agitated and unable to tolerate conventional preoxygenation methods, including face mask oxygen or noninvasive positive-pressure ventilation. Sedation with ketamine for preoxygenation, also known as delayed sequence intubation, is a technique that can be used to achieve preoxygenation in this patient population. No complications of delayed sequence intubation have previously been reported. A 60-year-old woman presented with acute hypoxic respiratory failure. Despite application of high-flow oxygen (60 L/min) with a nonrebreather face mask, her oxygen saturation remained at 93%...
January 2017: Annals of Emergency Medicine
Cameron Ratliff, Rebecca S Sayre, Mauricio Lepiz
A hand-reared, 53-kg, female, 30-day-old black rhinoceros ( Diceros bicornis ) calf presented for magnetic resonance imaging and computed tomography after demonstrating neurologic signs. The rhino was premedicated intramuscularly with butorphanol and midazolam, yielding satisfactory sedation. Induction was achieved using intravenous propofol until the trachea could be intubated. Anesthesia was maintained with sevoflurane in 100% oxygen (mean end-tidal concentration of 2 ± 0.5%). Mean values recorded during anesthesia included were heart rate, end-tidal carbon dioxide, respiratory rate, noninvasive blood pressure, and pulse oximetry...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Mehmet Levent Uygur, Ayşın Ersoy, Aysel Altan, Zekeriya Ervatan, Sedat Kamalı
OBJECTIVE: Haemodynamic variations are inevitable during induction of anaesthetic drugs. The present study investigates the haemodynamic variations of three different drugs (thiopental, propofol, and etomidate) used for induction of general anaesthesia together with fentanyl. METHODS: In a randomized, double-blind study, 45 patients were assigned to one of three groups (n=15 each). Fentanyl 1 μg kg(-1) was injected over 60 sec followed by propofol 2 mg kg(-1) (Group P), thiopentone 6 mg kg(-1) (Group T), or etomidate 0...
December 2014: Turkish Journal of Anaesthesiology and Reanimation
Hong-Xiu Diao, Shuai Zhang, Xue-Yuan Hu, Wei Guan, Li Luan, Hai-Yu Liu, Hong-Gang Fan
OBJECTIVE: To evaluate the behavior and some cardiopulmonary variables of dexmedetomidine-midazolam or dexmedetomidine-midazolam-butor-phanol in the silver fox (Vulpes vulpes). STUDY DESIGN: Blinded, randomized design. ANIMALS: Sixteen adult silver foxes, aged 7-9 months, weighting 6.0-9.2 kg. METHODS: Animals were randomly assigned to dexmedetomidine (50 μg kg(-1)) and midazolam (0.45 mg kg(-1)) (group DM) or to dexmedetomidine (30 μg kg(-1)), midazolam (0...
January 2017: Veterinary Anaesthesia and Analgesia
Mathieu Raillard, Julien Michaut-Castrillo, Damien Spreux, Olivier Gauthier, Gwenola Touzot-Jourde, Delphine Holopherne-Doran
OBJECTIVE: To compare the effects of intravenous (IV) medetomidine-morphine and medetomidine-methadone on preoperative sedation, isoflurane requirements and postoperative analgesia in dogs undergoing laparoscopic surgery. STUDY DESIGN: Randomized, crossover trial. ANIMALS: Twelve adult Beagle dogs weighing 15.1 ± 4.1 kg. METHODS: Dogs were administered medetomidine (2.5 μg kg(-1)) IV 5 minutes before either methadone (MET) or morphine (MOR) (0...
January 2017: Veterinary Anaesthesia and Analgesia
Alberto Zangrillo, Patrizio Mazzone, Carmine D Votta, Nicola Villari, Paolo Della Bella, Fabrizio Monaco
PURPOSE: Left atrial appendage (LAA) closure is an interventional procedure increasingly used to prevent stroke in patients with permanent atrial fibrillation and contraindications to anticoagulation therapy. As this procedure requires a relatively immobile patient and performance of continuous and prolonged transesophageal echocardiography (TEE), it is usually performed under general anesthesia. In this case series, we describe the feasibility of prolonged TEE for percutaneous LAA closure using a new noninvasive ventilation device that can avoid the need for endotracheal intubation and general anesthesia...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Alireza Eshghi, Mehrnaz Mohammadpour, Nasser Kaviani, Dana Tahririan, Najmeh Akhlaghi
BACKGROUND: Proper analgesic agents should be used in combination with sedative agents. Remifentanil is a synthetic narcotic/analgesic agent with a short duration effect and decreases the risk of apnea during recovery. Bispectral index system (BIS) is a new noninvasive technique for the evaluation of the depth of sedation. The aim of present clinical trial was to evaluate and compare the efficacy of intravenous sedation with propofol/midazolam/remifentanil (PMR) in comparison to propofol/midazolam/ketamine (PMK) for dental procedures in children 3-7 years of age...
January 2016: Dental Research Journal
Susanne Eberl, Benedikt Preckel, Jacques J Bergman, Susan van Dieren, Markus W Hollmann
BACKGROUND: Dexmedetomidine possesses anxiolytic and hypnotic properties without respiratory side-effects, making it theoretically an ideal sedative agent for endoscopic procedures. OBJECTIVE: We aimed to compare satisfaction and safety among outpatients receiving sedation with dexmedetomidine or propofol for endoscopic oesophageal procedures. DESIGN: A randomised controlled study. SETTING: Endoscopic intervention suite at the Academic Medical Centre in Amsterdam, Netherlands...
September 2016: European Journal of Anaesthesiology
Nicole M Baier, Suzanne S Mendez, Danielle Kimm, Amanda E Velazquez, Alan R Schroeder
OBJECTIVE: Dexmedetomidine is an α2 agonist with sedative, anxiolytic, and analgesic properties. The intranasal (IN) route avoids the pain of intravenous (i.v.) catheter placement but limited literature exists on the use of IN dexmedetomidine. This study examines the effectiveness and safety of IN dexmedetomidine for sedation of patients undergoing electroencephalogram (EEG) and auditory brain response (ABR) testing. STUDY DESIGN: This was a review of all outpatients sedated with IN dexmedetomidine for EEG or ABR between October 1, 2012 and October 1, 2014...
March 2016: Paediatric Anaesthesia
Ayhan Yaman, Tanıl Kendirli, Çağlar Ödek, Can Ateş, Nevin Taşyapar, Melek Güneş, Erdal İnce
PURPOSE: To determine the efficiency of noninvasive mechanical ventilation (NIV) both in protection from intubation and in preventing reintubation of postextubation in patients in the pediatric intensive care unit (PICU). METHODS: A prospective observational study was conducted in a multidisciplinary 10-bed tertiary PICU of a university hospital. All patients were admitted to our unit from June 2012 to May 2014 and deemed to be candidates to receive continuous positive airway pressure or bilevel positive airway pressure...
April 2016: Journal of Critical Care
Hironori Ishizaki, Yoshiaki Terao, Miwa Taniguchi, Sojiro Matsumoto, Akiko Sakai, Satoshi Egashira, Chikako Tsuji, Makoto Fukusaki, Tetsuya Hara
BACKGROUND: Non-invasive positive pressure ventilation (NPPV) reduces the incidences of ventilator-associated pneumonia, the duration of ICU stay and the mortality rate compared with conventional respiratory management of the patients with acute respiratory failure (ARF). Recently, helmet NPPV equipment became available. Because of the high tolerability, the helmet seems to be the best NPPV interface when prolonged and continuous assistance is needed. In this study, we analyzed several factors related to failure of helmet NPPV in ARF patients in intensive care unit (ICU), retrospectively...
October 2015: Masui. the Japanese Journal of Anesthesiology
Jacqueline A Hannam, Xavier Borrat, Iñaki F Trocóniz, José F Valencia, Erik W Jensen, Angela Pedroso, Jenifer Muñoz, Sergi Castellví-Bel, Antoni Castells, Pedro L Gambús
Respiratory depression is a common adverse effect of propofol and remifentanil. We aimed to develop a model for respiratory depressant effects of propofol with remifentanil in patients undergoing endoscopy with sedation. Data were available for 136 patients undergoing endoscopy with sedation. Participants randomly received infusions of propofol and remifentanil. Predicted plasma concentrations, outputted by infusion pumps, were available. Transcutaneous arterial pressure of carbon dioxide (pCO2) was measured...
March 2016: Journal of Pharmacology and Experimental Therapeutics
Susie So-Hyun Lee, Mitchell F Berman
In this case report, we describe the use of the Draeger Apollo anesthesia machine to deliver bilevel positive airway pressure (BiPAP) to a patient with severe chronic obstructive pulmonary disease and a history of lung resection undergoing frontal craniotomy for the removal of a brain tumor under moderate to deep sedation. BiPAP in the perioperative period has been described for purposes of preoxygenation and postextubation recruitment. Although its utility as a mode of ventilation during moderate to deep sedation has been demonstrated, it has not come into widespread use...
December 1, 2015: A & A Case Reports
H B Kellihan, R L Stepien, K M Hassen, L J Smith
OBJECTIVES: To evaluate the echocardiographic variables and sedation after two dosages of dexmedetomidine combined with butorphanol in healthy dogs. ANIMALS: Fourteen healthy dogs. METHODS: The dogs received dexmedetomidine 5 mcg/kg IM and butorphanol 0.4 mg/kg (low dose (LD), n = 6) or dexmedetomidine 10 mcg/kg IM and butorphanol 0.4 mg/kg (recommended dose (RD), n = 8). Sedation scoring, noninvasive blood pressure measurement, and echocardiography were performed before sedation at baseline, at 20 minutes (T20), and 60 minutes (T60) after drug administration...
December 2015: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Jose E Irazuzta, Martha E Brown, Javed Akhtar
OBJECTIVE: We determined whether the bedside assessment of the optic nerve sheath diameter could identify elevated intracranial pressure in individuals with suspected idiopathic intracranial hypertension. METHODS: This was a single-center, prospective, rater-blinded study performed in a freestanding pediatric teaching hospital. Patients aged 12 to 18 years scheduled for an elective lumbar puncture with the suspicion of idiopathic intracranial hypertension were eligible to participate...
January 2016: Pediatric Neurology
Nicolas A Villa, Rahul Pannala, Shabana F Pasha, Jonathan A Leighton
A thorough and complete colonoscopy is critically important in preventing colorectal cancer. Factors associated with difficult and incomplete colonoscopy include a poor bowel preparation, severe diverticulosis, redundant colon, looping, adhesions, young and female patients, patient discomfort, and the expertise of the endoscopist. For difficult colonoscopy, focusing on bowel preparation techniques, appropriate sedation and adjunct techniques such as water immersion, abdominal pressure techniques, and patient positioning can overcome many of these challenges...
November 2015: Current Gastroenterology Reports
Z Baykal Tutal, H Gulec, N Derelı, M Babayıgıt, A Kurtay, H Inceoz, E Horasanlı
BACKGROUND AND AIMS: In this study, we compared duration for reaching desired Ramsay Sedation Score (RSS) and postoperative recovery according to Modified Aldrete Score (MAS) of propofol and propofol-ketamine combination in a group of colonoscopy patients. Rates of cardiovascular, respiratory, laryngospasm, visual and nausea/vomiting complications were also compared as secondary outcomes. METHODS: This is a double-blinded prospective randomized controlled trial...
August 2016: Irish Journal of Medical Science
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