keyword
MENU ▼
Read by QxMD icon Read
search

Sedation interruption

keyword
https://www.readbyqxmd.com/read/29732181/optimising-drug-dosing-in-patients-receiving-extracorporeal-membrane-oxygenation
#1
REVIEW
Vesa Cheng, Mohd-Hafiz Abdul-Aziz, Jason A Roberts, Kiran Shekar
Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease and ECMO wean, minimisation of complications (treatment of complications when they do occur), early interruption of sedation and rehabilitation, maximising patient comfort and minimising risks of delirium. ECMO can alter both the pharmacokinetics (PK) and pharmacodynamics (PD) of administered drugs and our understanding of these alterations is still evolving...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29715354/effect-of-atropine-with-propofol-vs-atropine-with-atracurium-and-sufentanil-on-oxygen-desaturation-in-neonates-requiring-nonemergency-intubation-a-randomized-clinical-trial
#2
Xavier Durrmeyer, Sophie Breinig, Olivier Claris, Pierre Tourneux, Cénéric Alexandre, Elie Saliba, Alain Beuchée, Camille Jung, Corinne Levy, Laetitia Marchand-Martin, Marie-Odile Marcoux, Agnes Dechartres, Claude Danan
Importance: Propofol or a combination of a synthetic opioid and muscle relaxant are both recommended for premedication before neonatal intubation but have yet to be compared. Objective: To compare prolonged desaturation during neonatal nasotracheal intubation after premedication with atropine-propofol vs atropine-atracurium-sufentanil treatment. Design, Setting, and Participants: Multicenter, double-blind, randomized clinical trial (2012-2016) in 6 NICUs in France that included 173 neonates requiring nonemergency intubation...
May 1, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29708438/outcomes-of-protocolised-analgesia-and-sedation-in-a-neurocritical-care-unit
#3
Leana Mahmoud, Andrew R Zullo, Bradford B Thompson, Linda C Wendell
OBJECTIVES: Providing analgesia and sedation while allowing for neurological assessment is important in the neurocritical care unit (NCCU), yet data are limited about the effects of protocolised analgesia and sedation. We developed an analgesia-based sedation protocol and evaluated its effect on medication utilisation and costs in the NCCU. METHODS: We conducted a retrospective cohort study of patients who are mechanically ventilated and admitted to a 12-bed NCCU over four years...
April 30, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29578350/severe-cardiorespiratory-complications-derived-from-propofol-sedation-monitored-by-an-endoscopist
#4
Sergio Maestro Antolín, Bruno Antonio Moreira Da Silva, Fernando Santos Santamarta, Arantza Germade, Laura Pérez Citores, Ana Santamaría, Rocío Bonoso Criado, Rosa Eva Madrigal, Esther Saracibar, Javier Barcenilla Laguna, Francisco Igea Arisqueta, Antonio Germán Pérez-Millán
INTRODUCTION: deep sedation with propofol monitored by an endoscopist in different endoscopy units is a controversial subject and the source of conflicts of interest between the various scientific societies of Anesthesiology and Gastroenterology. Many studies have already demonstrated the efficacy, efficiency and low incidence of complications associated with sedation when under the control of a trained endoscopist vs an anesthesiologist. MATERIAL AND METHODS: the rate of severe cardiorespiratory complications during various endoscopic examinations (gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP] and endoscopic ultrasound [EUS]) where sedation was controlled by an endoscopist within our unit, from 2011 to 2016, was reviewed...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29561076/benefits-of-quiet-time-interventions-in-the-intensive-care-unit-a-literature-review
#5
Rimen Lim
Sleep disturbance is a significant issue for patients in intensive care units (ICUs), which can affect their health and recovery from illness. Therefore, it is important to consider ways to address sleep disturbance in these settings. One strategy that has been suggested is the use of 'quiet time' interventions, which involve a defined period where there is a reduction in controllable light and sound, and where interruptions at the patient's bedside are minimised. AIM: To determine the effectiveness of quiet time interventions in improving patients' sleep quality in ICUs; to investigate other potential clinical benefits of quiet time interventions; and to consider the effect of incorporating open visitation when implementing quiet time interventions...
March 21, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#6
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29550856/association-of-the-centers-for-medicare-medicaid-services-national-partnership-to-improve-dementia-care-with-the-use-of-antipsychotics-and-other-psychotropics-in-long-term-care-in-the-united-states-from-2009-to-2014
#7
Donovan T Maust, H Myra Kim, Claire Chiang, Helen C Kales
Importance: The Centers for Medicare & Medicaid Services' National Partnership to Improve Dementia Care in Nursing Homes (hereafter referred to as the partnership) was established to improve the quality of care for patients with dementia, measured by the rate of antipsychotic prescribing. Objective: To determine the association of the partnership with trends in prescribing of antipsychotic and other psychotropic medication among older adults in long-term care...
March 17, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29545985/the-effect-of-daily-sedation-weaning-application-on-morbidity-and-mortality-in-intensive-care-unit-patients
#8
Selcuk Kayir, Hulya Ulusoy, Guvenc Dogan
Background/aims Sedation is one of the most important components of intensive care unit (ICU) in patients who are mechanically ventilated at intensive care conditions. As a result of sedation and analgesia in the intensive care unit, the patient is to be awakened a comfortable and easy process. The aim of the study is to demonstrate the effects of day-time sedation interruptions in intensive care patients. Material and methods We made a retrospective review of 100 patients who were monitored, mechanically ventilated and treated at our intensive care unit between January 2008 and January 2013...
January 13, 2018: Curēus
https://www.readbyqxmd.com/read/29491750/sedation-protocol-during-bevacizumab-intravitreal-injection-in-preterm-infants-with-retinopathy-of-prematurity
#9
Jamie L Miller, Peter N Johnson, Kari Harkey, R Michael Siatkowski
OBJECTIVES: This study describes outcomes of intravenous (IV) analgesics and sedatives for bedside intravitreal bevacizumab injections for retinopathy of prematurity. METHODS: This retrospective study included infants receiving intravitreal bevacizumab injections between January 2012 and May 2016. Infants were excluded if bevacizumab was administered under general anesthesia or for incomplete records. Data collection included demographics, sedation and analgesia regimen, and cardiopulmonary adverse events (AEs)...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29464512/feasibility-of-continuous-sedation-monitoring-in-critically-ill-intensive-care-unit-patients-using-the-neurosense-wav-cns-index
#10
Nicholas West, Paul B McBeth, Sonia M Brodie, Klaske van Heusden, Sarah Sunderland, Guy A Dumont, Donald E G Griesdale, J Mark Ansermino, Matthias Görges
Sedation in the intensive care unit (ICU) is challenging, as both over- and under-sedation are detrimental. Current methods of assessment, such as the Richmond Agitation Sedation Scale (RASS), are measured intermittently and rely on patients' behavioral response to stimulation, which may interrupt sleep/rest. A non-stimulating method for continuous sedation monitoring may be beneficial and allow more frequent assessment. Processed electroencephalography (EEG) monitors have not been routinely adopted in the ICU...
February 20, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29383957/physician-perceptions-of-pharmacologic-treatment-options-for-chorea-associated-with-huntington-disease-in-the-united-states
#11
Victor W Sung, Ravi G Iyer, Sanjay K Gandhi, Bijal Shah-Manek, Marco DiBonaventura, Victor Abler, Daniel O Claassen
OBJECTIVE: To survey neurologists and obtain clinical perceptions of tetrabenazine for the treatment of chorea in patients with Huntington disease (HD). METHODS: Board-certified/board-eligible neurologists, in practice for ≥5 years, who had treated treat ≥3 HD patients in the past 2 years, were recruited from an online physician panel to participate in a cross-sectional, web-based survey. Respondents provided information about themselves, their practice, approaches to HD chorea management and perceptions of available treatments...
April 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29340298/efficacy-and-safety-of-sedation-during-endoscopic-submucosal-dissection-of-gastric-cancers-using-a-comparative-trial-of-propofol-versus-midazolam
#12
Hitomi Kikuchi, Takuto Hikichi, Ko Watanabe, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Yuki Sato, Katsutoshi Obara, Hiromasa Ohira
Background and study aims : Proper sedation is necessary for the safe and satisfactory completion of endoscopic submucosal dissection (ESD) for early gastric cancer. This study was conducted as a comparative trial of efficacy and safety, comparing propofol-based sedation and midazolam-based sedation during ESD of early gastric cancer patients. Patients and methods : This study examined 64 lesions in 58 patients treated using ESD with midazolam plus pentazocine between July 2013 and January 2014 (group M) and 237 lesions in 216 patients treated by ESD using propofol plus pentazocine between February 2014 and December 2015 (group P)...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29239457/opioids-and-immunosupression-in-oncological-postoperative-patients
#13
José Luis Bonilla-García, Manuel Cortiñas-Sáenz, Esperanza Del Pozo-Gavilán
INTRODUCTION: Recent animal studies demonstrated immunosuppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anesthesia Care Unit (PACU)-acquired infection after a schedule of sedoanalgesia of at least 6 days. METHOD: All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29220525/impact-of-opioid-dose-reduction-and-risk-mitigation-initiatives-on-chronic-opioid-therapy-patients-at-higher-risk-for-opioid-related-adverse-outcomes
#14
Manu Thakral, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Sascha Dublin, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Michael Von Korff
Objective: We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients. Design: Interrupted time series. Setting: Group Health Cooperative (GH), a health care delivery system and insurance within Washington State, between 2006 and 2014...
December 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29197598/effect-of-sedation-on-quantitative-electroencephalography-after-cardiac-arrest
#15
Callie M Drohan, Alessandra I Cardi, Jon C Rittenberger, Alexandra Popescu, Clifton W Callaway, Maria E Baldwin, Jonathan Elmer
BACKGROUND: Electroencephalography (EEG) has clinical and prognostic importance after cardiac arrest (CA). Recently, interest in quantitative EEG (qEEG) analysis has grown. The qualitative effects of sedation on EEG are well known, but potentially confounding effects of sedatives on qEEG after anoxic injury are poorly characterized. We hypothesize that sedation increases suppression ratio (SR) and decreases alpha/delta ratio (ADR) and amplitude-integrated EEG (aEEG), and that the magnitude of sedation effects will be associated with outcome...
March 2018: Resuscitation
https://www.readbyqxmd.com/read/29147474/new-onset-of-insomnia-in-hospitalized-patients-in-general-medical-wards-incidence-causes-and-resolution-rate
#16
An Ho, Bronson Raja, Richard Waldhorn, Valentina Baez, Idiris Mohammed
Background : Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method : This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29099542/chloral-hydrate-as-a-sedating-agent-for-neurodiagnostic-procedures-in-children
#17
REVIEW
Choong Yi Fong, Chee Geap Tay, Lai Choo Ong, Nai Ming Lai
BACKGROUND: Paediatric neurodiagnostic investigations, including brain neuroimaging and electroencephalography (EEG), play an important role in the assessment of neurodevelopmental disorders. The use of an appropriate sedative agent is important to ensure the successful completion of the neurodiagnostic procedures, particularly in children, who are usually unable to remain still throughout the procedure. OBJECTIVES: To assess the effectiveness and adverse effects of chloral hydrate as a sedative agent for non-invasive neurodiagnostic procedures in children...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29089921/the-neurological-wake-up-test-a-role-in-neurocritical-care-monitoring-of-traumatic-brain-injury-patients
#18
REVIEW
Niklas Marklund
The most fundamental clinical monitoring tool in traumatic brain injury (TBI) patients is the repeated clinical examination. In the severe TBI patient treated by continuous sedation in a neurocritical care (NCC) unit, sedation interruption is required to enable a clinical evaluation (named the neurological wake-up test; NWT) assessing the level of consciousness, pupillary diameter and reactivity to light, and presence of focal neurological deficits. There is a basic conflict regarding the NWT in the NCC setting; can the clinical information obtained by the NWT justify the risk of inducing a stress response in a severe TBI patient? Furthermore, in the presence of advanced multimodal monitoring and neuroimaging, is the NWT necessary to identify important clinical alterations? In studies of severe TBI patients, the NWT was consistently shown to induce a stress reaction including brief increases in intracranial pressure (ICP) and changes in cerebral perfusion pressure (CPP)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29018041/spontaneous-breathing-trials-and-conservative-sedation-practices-reduce-mechanical-ventilation-duration-in-subjects-with-ards
#19
EDITORIAL
Richard H Kallet, Hanjing Zhuo, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: Spontaneous breathing trials (SBTs) and daily sedation interruptions (DSIs) reduce both the duration of mechanical ventilation and ICU length of stay (LOS). The impact of these practices in patients with ARDS has not previously been reported. We examined whether implementation of SBT/DSI protocols reduce duration of mechanical ventilation and ICU LOS in a retrospective group of subjects with ARDS at a large, urban, level-1 trauma center. METHODS: All ARDS survivors from 2002 to 2016 ( N = 1,053) were partitioned into 2 groups: 397 in the pre-SBT/DSI group (June 2002-December 2007) and 656 in the post-SBT/DSI group (January 2009-April 2016)...
January 2018: Respiratory Care
https://www.readbyqxmd.com/read/28973626/delirium-in-older-persons-advances-in-diagnosis-and-treatment
#20
REVIEW
Esther S Oh, Tamara G Fong, Tammy T Hshieh, Sharon K Inouye
Importance: Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effects with substantial health care costs. Objective: To summarize the current state of the art in diagnosis and treatment of delirium and to highlight critical areas for future research to advance the field...
September 26, 2017: JAMA: the Journal of the American Medical Association
keyword
keyword
11380
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"