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Sedation monitoring

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https://www.readbyqxmd.com/read/27922904/utilization-of-quantitative-eeg-trends-for-critical-care-continuous-eeg-monitoring-a-survey-of-neurophysiologists
#1
Christa B Swisher, Saurabh R Sinha
PURPOSE: Quantitative EEG (QEEG) can be used to assist with review of large amounts of data generated by critical care continuous EEG monitoring. This study aimed to identify current practices regarding the use of QEEG in critical care continuous EEG monitoring of critical care patients. METHODS: An online survey was sent to 796 members of the American Clinical Neurophysiology Society (ACNS), instructing only neurophysiologists to participate. RESULTS: The survey was completed by 75 neurophysiologists that use QEEG in their practice...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#2
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918152/computed-tomographic-characteristics-of-the-thyroid-glands-in-eight-hyperthyroid-cats-pre-and-postmethimazole-treatment-compared-with-seven-euthyroid-cats
#3
Jennifer L Bush, Sarah Nemanic, Jana Gordon, Gerd Bobe
Hyperthyroidism is the most common feline endocrinopathy; thyroid computed tomography (CT) may improve disease detection and methimazole dose selection. Objectives of this experimental pre-post with historical case-control study were to perform thyroid CT imaging in awake or mildly sedated hyperthyroid cats, compare thyroid gland CT appearance in euthyroid and hyperthyroid cats pre- and postmethimazole treatment, and determine whether thyroid size or attenuation correlate with methimazole dose needed for euthyroidism...
December 5, 2016: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#4
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27907958/critical-care-management-after-cardiac-arrest
#5
Hans Friberg, Tobias Cronberg
Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#6
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27898164/dexmedetomidine-reduces-catheter-related-bladder-discomfort-a-prospective-randomized-placebo-controlled-double-blind-study
#7
Yang Zhao Yun, Xu Jun Mei, Zhu Rong, Dai Ru Ping, Liu Lei
OBJECTIVE: To evaluate the efficacy of dexmedetomidine in preventing catheterrelated bladder discomfort (CRBD) in a postanesthesia care unit (PACU). METHODS: A total of 138 consecutive adult male patients, classified by the American Society of Anesthesiologists (ASA) as ASA class I and ASA class II, were scheduled for elective open upper-middle abdominal surgery. They were randomized into 2 groups, C and D, comprising 69 patients each. Group C was given a saline solution as placebo, and group D received dexmedetomidine...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27888745/feasibility-of-eliciting-the-h-reflex-in-the-masseter-muscle-in-patients-under-general-anesthesia
#8
Sedat Ulkatan, Ana Maria Jaramillo, Maria J Téllez, Robert R Goodman, Vedran Deletis
OBJECTIVE: To explore the feasibility of eliciting the brainstem H reflex in the masseter muscle in patients under general anesthesia. METHODS: We electrically stimulated the masseteric nerve, a branch of the trigeminal nerve, and recorded ipsilateral masseteric and temporalis muscle responses. We tested eight patients who presented with trigeminal neuralgia; one patient had a temporal bone tumor and one patient had a brainstem arteriovenous malformation. All responses were elicited when patients were under general anesthesia and before the initiation of surgery...
November 5, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27882094/the-protective-and-hemodynamic-effects-of-dexmedetomidine-on-hypertensive-cerebral-hemorrhage-patients-in-the-perioperative-period
#9
Junhui Zhao, Chuixian Zhou
The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO2 and PETCO2 recorded 5 min after admission into the operation room was considered T1, the same parameters recorded 10 min after drug administration were considered T2, just after starting the operation were considered T3 and 30 min after start of operation were considered T4...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27876719/-local-anesthesia-selection-algorithm-in-patients-with-concomitant-disease-part-2
#10
E N Anisimova, S T Sokhov, N Yu Letunova, I V Orekhova, M V Gromovik, E A Erilin, N A Ryazantsev
A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.
2016: Stomatologii︠a︡
https://www.readbyqxmd.com/read/27876446/gastrostomy-tube-placement-is-safe-in-advanced-amyotrophic-lateral-sclerosis
#11
Manisha Kak, Naoum P Issa, Raymond P Roos, Bobbie Jean Sweitzer, Ori Gottlieb, Amy Guralnick, Steven R White, Carol E Semrad, Betty Soliven, Joumana Baroody, Kourosh Rezania
OBJECTIVES: To evaluate the safety and effect on survival of insertion of a gastrostomy tube (G-tube) in patients with amyotrophic lateral sclerosis (ALS) who have upright forced vital capacity (uFVC) ≤ 50% predicted. Current guidelines, which are based on higher rates of post-procedure complications in ALS patients with advanced respiratory dysfunction, have led to a recommendation to perform G-tube insertion before the FVC drops to <50% predicted, even when the patient has no significant dysphagia...
November 23, 2016: Neurological Research
https://www.readbyqxmd.com/read/27873285/prescription-drug-use-and-polypharmacy-among-medicaid-enrolled-adults-with-autism-a-retrospective-cross-sectional-analysis
#12
Rini Vohra, Suresh Madhavan, Usha Sambamoorthi, Claire StPeter, Susannah Poe, Nilanjana Dwibedi, Mayank Ajmera
BACKGROUND: A lack of gold standard treatment for autism spectrum disorders (ASD), no clear ASD management guidelines, and lack of evidence-based pharmacological interventions other than aripiprazole and risperidone elevate the risk of off-label prescribing and adverse effects among individuals with ASD, more so among adults. OBJECTIVE: The aim of this study was to identify and compare the types of prescription drug use, rates of polypharmacy, and characteristics associated with polypharmacy among adults with and without ASD in a retrospective cross-sectional analysis of a three-state Medicaid Analytic eXtract database (2000-2008)...
December 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#13
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27871631/-benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#14
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
November 18, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#15
Jose F Condado, Moosa N Haider, Stamatios Lerakis, Patricia Keegan, Hope Caughron, Vinod H Thourani, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Jessica Forcillo, Ateet Patel, Amy Simone, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: TF-TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety/efficacy of this technique in patients with severe COPD is unknown. METHODS: We compared demographics, 30-day outcomes and 1-year survival of patients with severe COPD (FEV1% ≤50) who underwent minimalist vs...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27857689/the-safety-and-efficacy-of-dexmedetomidine-vs-sufentanil-in-monitored-anesthesia-care-during-burr-hole-surgery-for-chronic-subdural-hematoma-a-retrospective-clinical-trial
#16
Wenming Wang, Lei Feng, Fenfen Bai, Zongwang Zhang, Yong Zhao, Chunguang Ren
Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery. Objective: To evaluate the safety and efficacy of DEX vs...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27856360/sensitivity-to-isoflurane-anesthesia-increases-in-autism-spectrum-disorder-shank3-%C3%A2-c-mutant-mouse-model
#17
Changsheng Li, Michele Schaefer, Christy Gray, Ya Yang, Orion Furmanski, Sufang Liu, Paul Worley, C David Mintz, Feng Tao, Roger A Johns
Autism is a heterogeneous developmental disorder characterized by impaired social interaction, impaired communication skills, and restricted and repetitive behavior. The abnormal behaviors of these patients can make their anesthetic and perioperative management difficult. Evidence in the literature suggests that some patients with autism or specific autism spectrum disorders (ASD) exhibit altered responses to pain and to anesthesia or sedation. A genetic mouse model of one particular ASD, Phelan McDermid Syndrome, has been developed that has a Shank3 haplotype truncation (Shank3(+/Δc))...
November 14, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#18
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27856078/not-everything-that-shakes-is-a-seizure%C3%A2-role-of-continuous-eeg-in-the-intensive-care-unit
#19
Thomas Ritzenthaler, Chloé Laurencin, Nathalie André Obadia, Carole Bodonian, Frédéric Dailler
Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. We report a case of suspected myoclonic status epilepticus. A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal...
November 14, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27850900/1264-sedation-agitation-scale-and-bispectral-index-to-monitor-sedation-depth-in-mechanically-ventilated
#20
Xiaofeng Ou, Yusi Hua, Wei Zhang, Ruiqiang Zheng, Hua Lin
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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