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https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#1
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#2
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27895443/the-validation-and-inter-rater-reliability-of-the-serbian-translation-of-the-richmond-agitation-and-sedation-scale-in-post-anesthesia-care-unit-patients
#3
Karlicic Stasevic, M Stasevic, S Jankovic, Dejanovic Djukic, A Dutina, I Grbic
BACKGROUND: Targeted light sedation is recommended because it shortens the time of mechanical ventilation and the length of stay in an intensive care unit (ICU). However, there is no validated scale for sedation and agitation in ICU in the Serbian speaking area. The aim of the current study was to validate, verify the reliability and enable the application of the Richmond Agitation and Sedation Scale (RASS) in the Serbian speaking area. METHODS: In this prospective cohort study, RASS was applied to 301 adult patients hospitalized in surgical ICUs by two different research team members...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#4
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27885664/haloperidol-plus-promethazine-for-psychosis-induced-aggression
#5
REVIEW
Gisele Huf, Jacob Alexander, Pinky Gandhi, Michael H Allen
BACKGROUND: Health services often manage agitated or violent people, and such behaviour is particularly prevalent in emergency psychiatric services (10%). The drugs used in such situations should ensure that the person becomes calm swiftly and safely. OBJECTIVES: To examine whether haloperidol plus promethazine is an effective treatment for psychosis-induced aggression. SEARCH METHODS: On 6 May 2015 we searched the Cochrane Schizophrenia Group's Register of Trials, which is compiled by systematic searches of major resources (including MEDLINE, EMBASE, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27884042/valproate-for-schizophrenia
#6
REVIEW
Yijun Wang, Jun Xia, Bartosz Helfer, Chunbo Li, Stefan Leucht
BACKGROUND: Many people with schizophrenia do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, and valproate is one of these. OBJECTIVES: To examine whether:1. valproate alone is an effective treatment for schizophrenia and schizoaffective psychoses; and2. valproate augmentation of antipsychotic medication is an effective treatment for the same illnesses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (July 2002; February 2007; July 2012; March 04, 2016)...
November 24, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27883227/preterm-infants-exhibited-less-pain-during-a-heel-stick-when-they-were-played-the-same-music-their-mothers-listened-to-during-pregnancy
#7
Lina Kurdahi Badr, Taline Demerjian, Tania Daaboul, Hanan Abbas, Mirvat Hasan Zeineddine, Lama Charafeddine
AIM: Playing music during painful procedures has shown inconsistent benefits for preterm infants. This study observed preterm infants during a heel stick procedure to assess whether listening to the music their mothers listened to during pregnancy had any impact on their pain, physiological and behavioural parameters. METHODS: We randomly exposed 42 preterm infants, with a mean gestational age of 31.8 ±2.79 weeks, to the music their mothers listened to during pregnancy, recorded lullabies and no music, before, during and after a heel stick...
November 24, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#8
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27854517/acute-kidney-injury-as-a-risk-factor-for-delirium-and-coma-during-critical-illness
#9
Edward D Siew, William H Fissell, Christina M Tripp, Jeffrey D Blume, Matthew D Wilson, Amanda J Clark, Andrew J Vincz, E Wesley Ely, Pratik P Pandharipande, Timothy D Girard
RATIONALE: Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. OBJECTIVE: To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. METHODS: In a prospective cohort study of ICU patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, non-renal organ failure, sepsis, prior mental status, and sedative exposure...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27850900/1264-sedation-agitation-scale-and-bispectral-index-to-monitor-sedation-depth-in-mechanically-ventilated
#10
Xiaofeng Ou, Yusi Hua, Wei Zhang, Ruiqiang Zheng, Hua Lin
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850648/1010-outcomes-of-an-icu-pain-agitation-sedation-protocol-in-oncology-mechanically-ventilated-patients
#11
Trisha Patel, Dana Bullick, Sharon Barniak, Sarah Fulcher, Meredith Grigsby, Dean Howarth, Joanne McGovern, Jeffrey Hoag
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#12
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/27847697/comparison-of-the-effect-of-open-and-closed-endotracheal-suctioning-methods-on-pain-and-agitation-in-medical-icu-patients-a-clinical-trial
#13
Raziyeh Dastdadeh, Abbas Ebadi, Amir Vahedian-Azimi
BACKGROUND: Endotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions. OBJECTIVES: The present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843963/comparative-evaluation-between-two-methods-of-induced-hypotension-with-infusion-of-remifentanil-and-labetalol-during-sinus-endoscopy
#14
Parvin Sajedi, Ali Rahimian, Gholamreza Khalili
OBJECTIVE: This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery. METHODS: In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0...
October 2016: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/27843463/the-comparison-between-effect-of-chloralhydrate-and-diphenhydramine-on-sedating-for-electroencephalography
#15
Afagh Hassanzadeh Rad, Vahid Aminzadeh
OBJECTIVE: Electroencephalography (EEG) is the most effective diagnostic tool in distinguishing epileptic seizure. Chloral hydrate (CH) is a sedative hypnotic drug, commonly used as a method of sedation in children aged<3 yr. Furthermore, diphenhydramine (DH) is a first generation antihistaminic drug (H1 receptor blocker) with anti-cholinergic effect. In this study, we aimed to compare the effects of CH and DH on sedating for EEG. MATERIALS & METHODS: This retrospective cohort study was conducted on patients' records of aged 15-72 months undergone an EEG and required sedation...
2016: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/27842924/dexmedetomidine-use-in-the-emergency-department-for-control-of-methamphetamine-induced-agitation-a-report-of-two-cases
#16
Rex Pui Kin Lam, Wai Lam Yip, Chi Keung Wan, Matthew Sik Hon Tsui
BACKGROUND: Chemical restraint is often required to control agitation induced by methamphetamine. Dexmedetomidine is an α-2 adrenergic receptor agonist with sedative, analgesic, and sympatholytic properties. Its use in the emergency department (ED) to control methamphetamine-induced agitation has not been reported. OBJECTIVE: To report two cases of methamphetamine-induced agitation successfully sedated with dexmedetomidine in the ED. CASE REPORT: The first case was a 42-year-old man with unstable emotion and violent behaviours after smoking methamphetamine...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27842752/management-of-sedation-and-paralysis
#17
REVIEW
Michael A Fierro, Raquel R Bartz
Sedatives are administered to decrease patient discomfort and agitation during mechanical ventilation and to maintain patient-ventilator synchrony. Titration of infusions and or bolus dosing to maintain light sedation goals according to validated scales is recommended. However, it is important to consider deeper sedation for patients with refractory patient-ventilator dyssynchrony (PVD) to prevent volutrauma and barotrauma. Deep sedation plus muscle relaxants may be required to treat PVD or to reduce oxygen consumption and carbon dioxide production...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27833480/a-comparison-of-oral-midazolam-and-oral-dexmedetomidine-as-premedication-in-pediatric-anesthesia
#18
V Jannu, R S Mane, M G Dhorigol, C S Sanikop
CONTEXT: Oral premedication is widely used in pediatric anesthesia to provide preoperative anxiolysis and ensure smooth induction. Midazolam is currently the most commonly used premedicant, but newer drugs such as the α2-agonists have emerged as alternatives for premedication in children. AIMS: The aim of this study was to compare clinical effects of oral midazolam and oral dexmedetomidine on preanesthetic sedation and postoperative recovery profile in children...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27828781/tracheal-extubation-of-patients-with-cervical-spine-injury-a-case-report-and-review-of-literature
#19
Aleksandra Nowicka, Narcis Ungureanu, Shyam Balasubramanian, Cyprian Mendonca
In patients with cervical spine injuries, emergence from anesthesia and tracheal extubation can prove as challenging to the anesthesiologist as the tracheal intubation. We report a case of a patient with a potentially unstable cervical spine injury who presented for a nonspinal surgery and experienced agitation on emergence from anesthesia. The use of an intravenous sedative was necessary to ensure cervical spine immobilization but was complicated by severe respiratory depression and the need for reintubation and admission to intensive care...
November 8, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27826189/behavioral-emergency-in-the-elderly-a-descriptive-study-of-patients-referred-to-an-aggression-response-team-in-an-acute-hospital
#20
Daniel Simpkins, Carmelle Peisah, Irene Boyatzis
AIM: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART) comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them. METHODS: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed...
2016: Clinical Interventions in Aging
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