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Icu sedation

Huan Mark Nguyen, Doreen Pon
OBJECTIVE: Evaluate recent clinical studies involving the use of dexmedetomidine (DEX) infusion for the treatment of delirium in the intensive care unit (ICU). METHODS: A literature search was conducted to identify peer-reviewed articles in MEDLINE (1966-June 2016) using the terms sedation, analgesic, dexmedetomidine, delirium, and critically ill adult patients. RESULTS: Two studies in the ICU setting reported the potential benefits of DEX for managing agitation during weaning from mechanical ventilation...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Ahmad Ismail
Providing effective pain management is necessary for all patients in the intensive care unit (ICU). Because of developmental considerations, caring for children may provide additional challenges. The purpose of this literature review is to describe key challenges in providing effective pain management in pediatric intensive care units (PICUs), with the aim of bringing about a better understanding by health care providers caring for children. Challenges of providing effective pain management in the PICU can be categorized into four levels...
October 15, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Ryan C Dillon, Jose-Alberto Palma, Christy L Spalink, Diana Altshuler, Lucy Norcliffe-Kaufmann, David Fridman, John Papadopoulos, Horacio Kaufmann
OBJECTIVE: Adrenergic crises are a cardinal feature of familial dysautonomia (FD). Traditionally, adrenergic crises have been treated with the sympatholytic agent clonidine or with benzodiazepines, which can cause excessive sedation and respiratory depression. Dexmedetomidine is a centrally-acting α 2-adrenergic agonist with greater selectivity and shorter half-life than clonidine. We evaluated the preliminary effectiveness and safety of intravenous dexmedetomidine in the treatment of refractory adrenergic crisis in patients with FD...
October 17, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
Sooyeon Kim, Sage P Kramer, Adam J Dugan, David J Minion, John C Gurley, Daniel L Davenport, Victor A Ferraris, Sibu P Saha
BACKGROUND: Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. METHODS: Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures...
October 12, 2016: International Journal of Surgery
Soumitra Sen, Philip Grgurich, Amanda Tulolo, Andrew Smith-Freedman, Yuxiu Lei, Anthony Gray, James Dargin
BACKGROUND: There are limited data on the efficacy of symptom-triggered therapy for alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU). OBJECTIVE: To evaluate the safety and efficacy of a symptom-triggered benzodiazepine protocol utilizing Riker Sedation Agitation Scale (SAS) scoring for the treatment of AWS in the ICU. METHODS: We performed a before-and-after study in a medical ICU. A protocol incorporating SAS scoring and symptom-triggered benzodiazepine dosing was implemented in place of a protocol that utilized the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale and fixed benzodiazepine dosing...
October 12, 2016: Annals of Pharmacotherapy
Karen K Y Koo, Karen Choong, Deborah J Cook, Margaret Herridge, Anastasia Newman, Vincent Lo, Gordon Guyatt, Fran Priestap, Eileen Campbell, Karen E A Burns, FranÇois Lamontagne, Maureen O Meade
BACKGROUND: The promotion of early mobilization following critical illness is tempered by national reports of patient and institutional barriers to this approach. We carried out a survey to assess current knowledge, perceptions and practices of Canadian physicians and physiotherapists with respect to acquired weakness and early mobilization in adults in the intensive care unit (ICU). METHODS: We conducted a cross-sectional, self-administered postal survey among critical care physicians and physiotherapists in all 46 academic ICUs in Canada in 2011-2012...
July 2016: CMAJ Open
Anthony T Gerlach, Danielle M Blais, G Morgan Jones, Pamela K Burcham, Stanislaw P Stawicki, Charles H Cook, Claire V Murphy
BACKGROUND: Dexmedetomidine is commonly used for sedation in the Intensive Care Unit (ICU), and its use may be associated with hypotension. We sought to determine predictors of dexmedetomidine-associated hypotension. METHODS: Retrospective, single-center study of 283 ICU patients in four adults ICUs over a 12 month period. Univariate analyses were performed to determine factors associated with dexmedetomidine-related hypotension. Risk factors significant at the 0...
July 2016: International Journal of Critical Illness and Injury Science
Laurent Lonjaret, Marine Guyonnet, Emilie Berard, Marc Vironneau, Françoise Peres, Sandrine Sacrista, Anne Ferrier, Véronique Ramonda, Corine Vuillaume, Franck Emmanuel Roux, Olivier Fourcade, Thomas Geeraerts
INTRODUCTION: After elective craniotomy for brain tumour surgery, patients are usually admitted to an intensive care unit (ICU) for monitoring. Our goal was to evaluate the incidence and timing of neurologic and non-neurologic postoperative complications after brain tumour surgery, to determine factors associated with neurologic events and to evaluate the timing and causes of ICU readmission. PATIENTS AND METHODS: This prospective, observational and analytic study enrolled 188 patients admitted to the ICU after brain tumour surgery...
October 4, 2016: Anaesthesia, Critical Care & Pain Medicine
Jennifer B Seaman, Amber E Barnato, Susan M Sereika, Mary Beth Happ, Judith A Erlen
OBJECTIVE: Describe patterns of palliative care service consultation among a sample of ICU patients at high risk of dying. BACKGROUND: Patients receiving mechanical ventilation (MV) face threats to comfort, social connectedness and dignity due to pain, heavy sedation and physical restraint. Palliative care consultation services may mitigate poor outcomes. METHODS: From a dataset of 1440 ICU patients with ≥2 days of MV and ≥12 h of sustained wakefulness, we identified those at high risk of dying and/or who died and assessed patterns of sub-specialty palliative care consultation...
October 4, 2016: Heart & Lung: the Journal of Critical Care
S Sivakumar, F S Taccone, K A Desai, C Lazaridis, M Skarzynski, M Sekhon, W Henderson, D Griesdale, L Chapple, A Deane, L Williams, R Strickland, K Lange, D Heyland, M Chapman, M J Rowland, P Garry, J Westbrook, R Corkill, C A Antoniades, K T Pattinson, G Fatania, A J Strong, R B Myers, C Lazaridis, C M Jermaine, C S Robertson, C G Rusin, J Hofmeijer, L Sondag, M C Tjepkema-Cloostermans, A Beishuizen, F H Bosch, M J A M van Putten, L Carteron, C Patet, D Solari, M Oddo, M A Ali, C Dias, R Almeida, A Vaz-Ferreira, J Silva, E Monteiro, A Cerejo, A P Rocha, A A Elsayed, A M Abougabal, B N Beshey, K M Alzahaby, S Pozzebon, A Blandino Ortiz, S Cristallini, O Lheureux, A Brasseur, J L Vincent, J Creteur, F S Taccone, M Hravnak, K Yousef, Y Chang, E Crago, R M Friedlander, S A Abdelmonem, S A Tahon, T A Helmy, H S Meligy, F Puig, I Dunn-Siegrist, J Pugin, S Gupta, D Govil, S Srinivasan, S J Patel, J K N, A Gupta, D S Tomar, M Shafi, R Harne, D P Arora, N Talwar, S Mazumdar, E E Papakrivou, D Makris, E Manoulakas, B Tsolaki, B Karadodas, E Zakynthinos, I Palacios Garcia, A Diaz Martin, V Sanchez Encinares, M Pachón Ibañez, J Garnacho Montero, G Labrador, T Cebrero Cangueiro, V Poulose, J Koh, J W Kam, H Yeter, A Kara, O Aktepe, A Topeli, I Tsolakoglou, G Intas, P Stergiannis, A A Kolaros, E Chalari, E Athanasiadou, A Martika, G Fildisis, V Faivre, C Mengelle, B Favier, D Payen, A Poppe, M S Winkler, E Mudersbach, J Schreiber, M L Wruck, E Schwedhelm, S Kluge, C Zöllner, T Tavladaki, A M Spanaki, H Dimitriou, E Kondili, C Choulaki, E Meleti, D Kafetzopoulos, D Georgopoulos, G Briassoulis, A García-de la Torre, M V de la Torre-Prados, T Tsvetanova-Spasova, P Nuevo-Ortega, C Rueda-Molina, A Fernández-Porcel, E Camara-Sola, L Salido-Díaz, A García-Alcántara, T Tavladaki, A M Spanaki, H Dimitriou, E Kondili, C Choulaki, D E Meleti, D Kafetzopoulos, D Georgopoulos, G Briassoulis, B Suberviola, J Riera, L Rellan, M Sanchez, J C Robles, E Lopez, R Vicente, E Miñambres, M Santibañez, M Le Guen, J Moore, N Mason, M Windpassinger, O Plattner, E Mascha, D I Sessler, Outcomes Research, U Melia, J Fontanet, J P van den Berg, M M R F Struys, H E M Vereecke, E W Jensen, P J T Rood, F van de Schoor, K van Tertholen, P Pickkers, M van den Boogaard, Z J Beardow, H Redhead, K Paramasivam, T Numan, M van den Boogaard, A M Kamper, P Rood, L M Peelen, P M Zeman, A J Slooter, C E van Ewijk, G E Jacobs, A R J Girbes, S N Myatra, M M Harish, N R Prabu, S Siddiqui, A P Kulkarni, J V Divatia, L D Murbach, M A Leite, E F Osaku, C R L M Costa, M Pelenz, N M Neitzke, M M Moraes, J L Jaskowiak, M M M Silva, R S Zaponi, L R L Abentroth, S M Ogasawara, A C Jorge, P A D Duarte, N Hernández-Sánchez, L A Sánchez-Hurtado, F J García-Guillen, S A Ñamendys-Silva, B Maghsoudi, M Emami, M B Khosravi, F Zand, H R Tabatabaie, M Masjedi, G Sabetiyan, A Mokri, J Troubleyn, M Diltoer, R Jacobs, D N Nguyen, E De Waele, J De Regt, P M Honoré, V Van Gorp, H D Spapen, R S Contreras, N D Toapanta, G Moreno, J Sabater, H Torrado, M Gonzalez, M Marin, E Farigola, A Gonzalez, J Fernandez, A Vera, X Gisbert, C Juliá, J Uya, L Corral, I Elias-Jones, L Gemmell, A MacKay, D Randall, A Adwaney, M Blunden, J R Prowle, C J Kirwan, N Thomas, A Martin, H Owen, L Darwin, D Conway, D Atkinson, M Sharman, J Moore, C Barbanti, J Amour, P Gaudard, B Rozec, P Mauriat, M M'rini, P L Leger, G Cambonie, J M Liet, C Girard, S Laroche, P Damas, Z Assaf, G Loron, L Lecourt, P Pouard, D Randall, A Adwaney, M Blunden, J R Prowle, C J Kirwan, S H Kim, S Na, J Kim, S Y Oh, C W Jung, S H Yoo, S H Min, E J Chung, H Lee, N J Lee, K W Lee, K S Suh, H G Ryu, D C Marshall, R J Goodson, J D Salciccioli, J Shalhoub, E K Potter, J Kirk-Bayley, N D Karanjia, L G Forni, B C Creagh-Brown, M Bossy, M Nyman, A Tailor, B Creagh-Brown, D D'Antini, S Spadaro, F Valentino, F Sollitto, G Cinnella, L Mirabella, F J Redondo Calvo, N Bejarano, D Padilla, V Baladron, P Villajero, R Villazala, J Redondo, A S Yuste, J Liu, F Shen, J L Teboul, N Anguel, A Beurton, N Bezaz, C Richard, X Monnet, T Fossali, R Colombo, D Ottolina, M Rossetti, C Mazzucco, A Marchi, A Porta, E Catena, K H Tollisen, G Ø Andersen, F Heyerdahl, D Jacobsen, M C de Waard, A R J Girbes, M C O van IJzendoorn, H Buter, W P Kingma, G J Navis, E C Boerma, J Rulisek, M Balik, S Zacharov, H S Kim, S J Jeon, H Namgung, E Lee, E Lee, Y J Cho, Y J Lee, A Huang, L Cioccari, N Luethi, J Mårtensson, R Bellomo, M Forsberg, G Edman, J Höjer, S Forsberg, M T Chiquito Freile, F N Hidalgo, J A Martinez Molina, R Lecumberri, A Figuerola Rosselló, P Medrano Travieso, G Tuero Leon, J Gonzalez Sanchez, L Sahuquillo Frias, D Balsells Rosello, J A Garcia Verdejo, J A Noria Serrano, D Winterwerp, T van Galen, A Vazin, I Karimzade, A Zand, E Ozen, S Ekemen, A Akcan, E Sen, B Buyukkidan Yelken, N Kureshi, L Fenerty, G Thibault-Halman, M Erdogan, S Walling, R S Green, D B Clarke, P Briassoulis, K Kalimeris, A Ntzouvani, T Nomikos, K Papaparaskeva, E Politi, G Kostopanagiotou, K Crewdson, M Rehn, A Weaver, K Brohi, D Lockey, S Wright, K Thomas, C Baker, L Mansfield, V Stafford, C Wade, G Watson, A Bryant, T Chadwick, J Shen, J Wilkinson, J Furneval, A Henderson, K Hugill, P Howard, A Roy, S Bonner, S Baudouin, C Sánchez Ramírez, S Hípola Escalada, M A Hernández Viera, M Cabrera Santana, L Caipe Balcázar, N Sangil Monroy, F Artiles Campelo, C F Lübbe Vázquez, P Saavedra Santana, S Ruiz Santana, L Carteron, C Patet, H Quintard, D Solari, P Bouzat, M Oddo, T Wollersheim, J Malleike, K Haas, N Carbon, J Schneider, C Birchmeier, J Fielitz, S Spuler, S Weber-Carstens, L Enseñat, A Pérez-Madrigal, P Saludes, L Proença, G Gruartmoner, C Espinal, J Mesquida, W Huber, M Eckmann, F Elkmann, A Gruber, T Lahmer, U Mayr, A Herner, R Schellnegger, J Schneider, R M Schmid, W Ayoub, W Samy, A Esmat, A Battah, S Mukhtar, W Mongkolpun, D Orbegozo Cortés, C P R Cordeiro, J L Vincent, J Creteur, S Funcke, H Groesdonk, B Saugel, G Wagenpfeil, S Wagenpfeil, D A Reuter, M M Fernandez, R Fernandez, M Magret, A González-Castro, M T Bouza, M Ibañez, C García, B Balerdi, A Mas, V Arauzo, J M Añón, F Ruiz, J Ferreres, R Tomás, M Alabert, A I Tizón, S Altaba, N Llamas, E C Goligher, E Fan, M Herridge, S Vorona, M Sklar, M Dres, N Rittayamai, A Lanys, C Urrea, G Tomlinson, W D Reid, G D Rubenfeld, B P Kavanagh, L J Brochard, N D Ferguson, A Serpa Neto, M Gama de Abreu, P Pelosi, M J Schultz, C Guérin, L Papazian, J Reignier, L Ayzac, A Loundou, J M Forel, C Rolland-Debord, C Bureau, T Poitou, M Clavel, S Perbet, N Terzi, A Kouatchet, T Similowski, A Demoule, N Hunfeld, Z Trogrlic, S Ladage, R J Osse, B Koch, W Rietdijk, J Devlin, M van der Jagt, E Picetti, P Ceccarelli, F Mensi, L Malchiodi, S Risolo, I Rossi, M V Antonini, F Servadei, M L Caspani, A Roquilly, S Lasocki, P Seguin, T Geeraerts, P F Perrigault, C Dahyot-Fizelier, C Paugam-Burtz, F Cook, R Cinotti, D Demeure Dit Latte, P J Mahe, C Fortuit, F Feuillet, K Asehnoune, C Marzorati, S Spina, V Scaravilli, A Vargiolu, M Riva, C Giussani, E Sganzerla, G Citerio, S Barbadillo, F J González de Molina, F Álvarez-Lerma, A Rodríguez, T Zakharkina, I Martin-Loeches, S Matamoros, P Povoa, A Torres, J Kastelijn, J J Hofstra, M de Jong, M Schultz, P Sterk, A Artigas, L J Bos, A S Moreau, I Martin-Loeches, P Povoa, J Salluh, A Rodriguez, S Nseir, E de Jong, J A van Oers, A Beishuizen, A R J Girbes, M W N Nijsten, D W de Lange, D Bonvicini, D Labate, L Benacchio, A Olivieri, E Pizzirani, J C Lopez-Delgado, M Gonzalez-Romero, V Fuentes-Mila, D Berbel-Franco, I Romera-Peregrina, A Martinez-Pascual, J Perez-Sanchez, R Abellan-Lencina, R E Ávila-Espinoza, G Moreno-Gonzalez, F Sbraga, S Griffiths, M P W Grocott, B Creagh-Brown, J Doyle, P Wilkerson, Y Soon, S Huddart, M Dickinson, A Riga, A Zuleika, K Miyamoto, Y Kawazoe, T Morimoto, T Yamamoto, A Fuke, A Hashimoto, H Koami, S Beppu, Y Katayama, M Ito, Y Ohta, H Yamamura, S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner, I W Soliman, D W de Lange, D van Dijk, J J M van Delden, O L Cremer, A J C Slooter, L M Peelen, D McWilliams, C Snelson, A Das Neves, C I Loudet, M Busico, D Vazquez, D Villalba, M Veronesi, A Lischinsky, F J L López, L Benito Mori, G Plotnikow, A Díaz, S Giannasi, R Hernandez, L Krzisnik, C Cecotti, L Viola, R Lopez, J P Sottile, G Benavent, E Estenssoro, C M Chen, C C Lai, K C Cheng, W Chou, K S Chan, L E Roeker, C M Horkan, F K Gibbons, K B Christopher, P J M Weijs, K M Mogensen, J D Rawn, M K Robinson, K B Christopher, Z Tang, C Qiu, B Ouyang, C Cai, X Guan, T Regueira, L Cea, S Juan Carlos, B Elisa, C Puebla, A Vargas, M K Poulsen, L P Thomsen, S Kjærgaard, S E Rees, D S Karbing, T Wollersheim, S Frank, M C Müller, N M Carbon, V Skrypnikov, P A Pickerodt, R Falk, A Mahlau, S Weber-Carstens, A Lee, R Inglis, R Morgan, G Barker, K Kamata, T Abe, D Saitoh, Y Tokuda, R S Green, M B Butler, M Erdogan, H Tae Hwa, L Jae Gil, R Hernández Vaquero, E Rodriguez-Ruiz, A Lopez Lago, J L Garcia Allut, A Estany Gestal, M A Garcia Gonzalez, D O Thomas-Rüddel, D Schwarzkopf, C Fleischmann, K Reinhart, S Suwanpasu, Y Sattayasomboon, N M Filgueiras Filho, J C A Oliveira, C S Ballalai, C V De Lucia, G P Araponga, L N Veiga, C S Silva, M E Garrido, B B Ramos, E F Ricaldi, S S Gomes, L Gemmell, A MacKay, C Wright, R I Docking, P Doherty, E Black, P Stenhouse, M P Plummer, M E Finnis, L K Phillips, P Kar, S Bihari, V Biradar, S Moodie, M Horowitz, J E Shaw, A M Deane, T Yatabe, S Inoue, M Sakaguchi, M Egi, Y Ali Abdelhamid, M P Plummer, M E Finnis, L K Phillips, P Kar, S Bihari, V Biradar, S Moodie, M Horowitz, J E Shaw, A M Deane, M Hokka, M Egi, S Mizobuchi, P Kar, M Plummer, Y Ali Abdelhamid, E Giersch, M Summers, S Hatzinikolas, S Heller, M Chapman, K Jones, M Horowitz, A Deane, R Schweizer, M Jacquet-Lagreze, P Portran, S Junot, B Allaouchiche, J L Fellahi, P Guerci, B Ergin, A Kapucu, C Ince, L Cioccari, N Luethi, M Crisman, R Bellomo, J Mårtensson, C Righy Shinotsuka, D Fagnoul, A Brasseur, D Orbegozo, J L Vincent, J C Preiser, J C Preiser, O Lheureux, A Thooft, S Brimioulle, J L Vincent, H Iwasaka, S Tahara, M Nagamine, A Ichigatani, A Rugerio Cabrera, E Monares Zepeda, J Franco Granillo, J S Aguirre Sánchez, A A Tanaka Montoya, A Pedraza Montenegro, G A Gálvez Blanco, C M Coronado Robles, A Drolz, T Horvatits, K Roedl, K Rutter, S Kluge, G C Funk, B Schneeweiss, V Fuhrmann, G Sabetian, F Pooresmaeel, F Zand, S Ghaffaripour, A Farbod, H Tabei, L Taheri, R Anandanadesan, V Metaxa, C Teixeira, S M Pereira, P Hernández-Marrero, A S Carvalho, M Beckmann, C S Hartog, D Schwarzkopf, A Raadts, A Robertsen, R Førde, N O Skaga, E Helseth, S Honeybul, K Ho, P Martinez Lopez, M Nieto Gonzalez, P Nuevo Ortega, E Camara Sola, T Spasova, M V de la Torre-Prados, O Kopecky, K Rusinova, P Waldauf, Z Cepeplikova, M Balik, J Palamidessi Domínguez, P Matia Almudevar, S Alcántara Carmona, J J Rubio Muñoz, D Palacios Castañeda, A Naharro Abellán, P Rodríguez Villamizar, J Veganzones Ramos, L Pérez Pérez, A Pérez Lucendo, M Camós Ejarque, A Estella, V Lopez Camps, M C Martín, N Masnou, S Barbosa, A Varela, I Palma, L Cristina, E Nunes, I Pereira, G Campello, C Granja, R Pande, M Pandey, S Varghese, M Chanu, M J Van Dam, E W M T Ter Braak, A Estella, M Gracia, R Viciana, M Recuerda, L Perez Fontaiña, B Tharmalingam, F Kovari, L Rose, M Mcginlay, R Amin, K Burns, B Connolly, N Hart, P Jouvet, S Katz, D Leasa, C Mawdsley, D Mcauley, M Schultz, B Blackwood, S Denham, R Worrall, M Arshad, P Isherwood, A Khadjibaev, D Sabirov, A Rosstalnaya, F Parpibaev, V Sharipova, G A Galvez Blanco, C I Olvera Guzman, J S Aguirre Sánchez, J Franco Granillo, S Gupta, D Govil, S Srinivasan, S J Patel, J K N, A Gupta, M Shafi, D S Tomar, R Harne, D P Arora, N Talwar, S Mazumdar, Y S Cha, S J Lee, N Tyagi, R K Rajput, S Taneja, V K Singh, S C Sharma, S Mittal, B K Rao, J Ayachi, N Fraj, S Romdhani, A Khedher, K Meddeb, N Sma, A Azouzi, R Bouneb, I Chouchene, M El Ghardallou, M Boussarsar, R Jennings, E Walter, J M Ribeiro, I Moniz, R Marçal, A C Santos, C Candeias, Z Costa E Silva, S E Zamora Gomez, O R Perez Nieto, J A Castanon Gonzalez, A I Vasquez Cuellar, H Mildh, V Pettilä, A M Korhonen, S Karlsson, T Ala-Kokko, M Reinikainen, S T Vaara, M Zaleska-Kociecka, M Grabowski, M Dąbrowski, S Wozniak, K Piotrowska, M Banaszewski, J Imiela, J Stepinska, A González Pérez, P Florez Ordoñez, A Giribet, M A Alonso Cuervo, R Alonso Cuervo, M A Rodriguez Esteban, L Iglesias Fraile, C Ponte Mittelbrum, G Muñiz Albaiceta, J Koeze, F Keus, W Dieperink, I C C van der Horst, M van Meurs, J G Zijlstra, S Roberts, C Hernandez Caballero, G Isgro, D Hall, S Beitland, A-M S Trøseid, B S Brusletto, B E Waldum-Grevbo, J P Berg, K Sunde, D García Huertas, F Manzano, M M Jiménez- Quintana, A Osuna, F Santiago-Ruiz, C Rodríguez-Mejías, R Wangensteen, H R Jamaati, M Masjedi, F Zand, S M R Hashemian, G Sabetian, G Abbasi, V Khaloo, S H A Tabei, A Kafilzadeh, H Haddad Bakhodaei, J A Diaz, R Silva, D J Garcia, E Luis, M N Gomez, R Soriano, P L Gonzalez, I A Ibrahim, M M Rafik, A M Al-Ansary, M A Algendi, A A Ali, V Fuhrmann, K Roedl, T Horvatits, A Drolz, K Rutter, D Benten, J Kluwe, S Siedler, S Kluge, I Adedugbe, G T Bird, R M Kennedy, S Sharma, M B Butler, G Yugi, B A Haroon, T Witter, W Khaliq, M Singer, A A Havaldar, B Krishna, S Sriram, E D Valenzuela Espinoza, M O Pozo, V S Kanoore Edul, M Furche, M F Motta, A Risso Vazquez, P N Rubatto Birri, C Ince, A Dubin, A Dogliotti, A Ramos, C Lovesio, E Delile, R Nevière, P-A Thiébaut, J Maupoint, P Mulder, D Coquerel, S Renet, J C do Rego, J Rieusset, V Richard, F Tamion, W Khaliq, D T Andreis, M Singer, B Smit, Y M Smulders, M C de Waard, H M Oudemans van Straaten, A R J Girbes, E C Eringa, A M E Spoelstra-de Man, L Alegría, D Soto, C Luengo, J Gomez, N Jarufe, A Bruhn, R Castro, E Kattan, P Tapia, R Rebolledo, P Achurra, G Ospina-Tascón, J Bakker, G Hernández, P Bertini, F Guarracino, R Baldassarri, M R Pinsky, L Alegría, M Vera, J Dreyse, D Carpio, C Henriquez, D Gajardo, S Bravo, R Castro, G Ospina-Tascón, J Bakker, G Hernández, S Kim, M Lee, S Y Park, S So, H Lee, M B Kačar, S M Kačar, I Uddin, A M Belhaj, M A Aydın, D Avsec, A Kapuağası, Ç Kaymak, L Kovach, I Şencan, B Meço, M Özçelik, N Ünal, C Lazaridis, B Jenni-Moser, M-M Jeitziner, M S Galassi, F L Sales, K C L de Moraes, C L Batista, J A de Souza Júnior, T B Marcari, R Lobato, C S A A Castro, L M de Souza, F F P Rodrigues, N G Correa, A M Pelegrini, R A C Eid, K T Timenetsky, D Cazati, M Lobato, P S Diniz, L L Rocha, A M Cavalheiro, N M Lucinio, E R Santos, M Norrenberg, A Gleize, J C Preiser, I Fernández Simón, S Alcántara Carmona, I Lipperheide Valhonrat, J Palamidessi Domínguez, A Naharro Abellán, P Matía Almudévar, F Dávila, J J Rubio, A J Ramos, Á J Roldán Reina, N Palomo López, M Adriaensens Pérez, D X Cuenca Apolo, L Martín Villén, F M Porras López, I Palacios García, J R Naranjo 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No abstract text is available yet for this article.
September 2016: Intensive Care Medicine Experimental
Satomi Mori, Juliana Rumy Tsuchihashi Takeda, Fernanda Souza Angotti Carrara, Cibelli Rizzo Cohrs, Suely Sueko Viski Zanei, Iveth Yamaguchi Whitaker
OBJECTIVES: To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. METHOD: Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium...
July 2016: Revista da Escola de Enfermagem da U S P
Sylvain Fazilleau
OBJECTIVE: Early verticalization in ICU is recommended [1] but not documented in brain-damaged people. Using a verticalization table involves risks and stresses in this context. The main objective was to determine the safety and feasibility of in-bed verticalization in neurological intensive care. Secondary objectives were to study the immediate, hemodynamic, and respiratory impacts, as well as the effects on awakening. MATERIAL/PATIENTS AND METHODS: Observational study in a neurological intensive care unit...
September 2016: Annals of Physical and Rehabilitation Medicine
Donghao Wang, Yongmei Cao, Yi Lyu, Yingchuan Li, Tao Han
PURPOSE: To evaluate the corrective effect of norepinephrine on hypotension induced by dexmedetomidine through monitoring sedation status, hemodynamics as well as oxygen metabolism. METHODS: 100 patients administered standard-dose dexmedetomidine therapy with RASS between -2 and 0 in the intensive care unit (ICU) were included in the study. According to the application of norepinephrine to correct hypotension after dexmedetomidine therapy, the patients were divided into two groups: group A and group B...
September 26, 2016: International Journal of Clinical Pharmacology and Therapeutics
Lawrence A DeLuca, Paul Walsh, Donald D Davidson, Lisa R Stoneking, Laurel M Yang, Kristi J H Grall, M Jessica Gonzaga, Wanda J Larson, Uwe Stolz, Dylan M Sabb, Kurt R Denninghoff
BACKGROUND: Ventilator-associated pneumonia (VAP) has been linked to emergency department (ED) intubation and length of stay (LOS). We assessed VAP prevalence in ED intubated patients, feasibility of ED VAP prevention, and effect on VAP rates. METHODS: This was a quality improvement initiative using a pre/post design. Phase 1 (PRE1) comprised patients before intensive care unit (ICU) bundle deployment. Phase 2 (PRE2) occurred after ICU but before ED deployment. Phase 3 (POST) included patients received VAP prevention starting at ED intubation...
September 21, 2016: American Journal of Infection Control
Mevlut Karatas, Sedat Saylan, Ugur Kostakoglu, Gurdal Yilmaz
OBJECTIVES: Ventilator-associated pneumonia (VAP) is a significant cause of hospital-related infections, one that must be prevented due to its high morbidity and mortality. The purpose of this study was to evaluate the incidence and risk factors in patients developing VAP in our intensive care units (ICUs). METHODS: This retrospective cohort study involved in mechanically ventilated patients hospitalized for more than 48 hours. VAP diagnosed patients were divided into two groups, those developing pneumonia (VAP(+)) and those not (VAP(-))...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Giovanni Mistraletti, Michele Umbrello, Stefania Anania, Elisa Andrighi, Alessandra Di Carlo, Federica Martinetti, Serena Barello, Giovanni Sabbatini, Paolo Formenti, Tommaso Maraffi, Francesco Marrazzo, Alessandra Palo, Giacomo Bellani, Riccarda Russo, Silvia Francesconi, Federico Valdambrini, Marco Cigada, Francesca Riccardi, Egidio A Moja, Gaetano Iapichino
BACKGROUND: International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. METHODS: Multicenter, randomized, before and after study...
September 20, 2016: Minerva Anestesiologica
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
T Saller, V V Dossow, K Hofmann-Kiefer
BACKGROUND: Delirium is a common complication in critical care. The syndrome is often underestimated due to its potentially no less dangerous course as a hypoactive delirium. Therefore, current guidelines ask for a structured, regular and routine screening in all intensive care units. If delirium is diagnosed, symptomatic therapy should be initiated promptly. OBJECTIVES: The aim of the current study was to evaluate recent German anesthetists' strategies regarding delirium care compared to the German guidelines for sedation and delirium in intensive care...
October 2016: Der Anaesthesist
Andrew C Faust, Pearl Rajan, Lyndsay A Sheperd, Carlos A Alvarez, Phyllis McCorstin, Rebecca L Doebele
BACKGROUND: Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a "lighter" depth of sedation. Among these strategies are "analgosedation" protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously infused sedatives such as propofol or midazolam. We hypothesized that using an analgosedation protocol would result in a shorter duration of mechanical ventilation than a protocol with greater emphasis on IV sedatives METHODS: : We conducted a retrospective study comparing the duration of mechanical ventilation before and after implementation of an analgosedation protocol in a 24-bed medical ICU...
October 2016: Anesthesia and Analgesia
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