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Long term sedation

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https://www.readbyqxmd.com/read/28425334/remifentanil-for-sedation-of-children-with-traumatic-brain-injury
#1
James L Hungerford, Nicole O'Brien, Melissa Moore-Clingenpeel, Eric A Sribnick, Cheryl Sargel, Mark Hall, Jeffrey R Leonard, Joseph D Tobias
OBJECTIVE: To determine whether remifentanil would provide adequate sedation while allowing frequent and reproducible neurologic assessments in children admitted to the pediatric intensive care unit (PICU) with traumatic brain injury (TBI) during mechanical ventilation. DESIGN: Retrospective review. SETTING: Tertiary care PICU. PATIENTS: Thirty-eight patients over a 30-month period. MEASUREMENTS AND MAIN RESULTS: Median age was 9 years (interquartile range [IQR] 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28422846/application-of-remifentanil-for-conscious-sedation-and-analgesia-in-short-term-ercp-and-est-surgery
#2
Guo-Qiang Sun, Bao-Feng Gao, Guan-Jun Li, Yun-Long Lei, Jie Li
This study aims to observe and evaluate the use of remifentanil in conscious sedation and analgesia for the safety and comfort of patients undergoing short-term endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST).Sixty-eight patients who underwent ERCP and EST were randomly divided into two groups: research group and control group. Patients in the research group were intravenously injected with remifentanil (80-2/3* age) for 1 to 2 minutes, combined with the intravenous injection of propofol (20-30 mg) during the course of treatment...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28401119/long-term-sedative-use-among-community-dwelling-adults-a-population-based-analysis
#3
Deirdre Weymann, Emilie J Gladstone, Kate Smolina, Steven G Morgan
BACKGROUND: Chronic use of benzodiazepines and benzodiazepine-like sedatives (z-drugs) presents substantial risks to people of all ages. We sought to assess trends in long-term sedative use among community-dwelling adults in British Columbia. METHODS: Using population-based linked administrative databases, we examined longitudinal trends in age-standardized rates of sedative use among different age groups of community-dwelling adults (age ≥ 18 yr), from 2004 to 2013...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28388992/long-term-outcomes-of-560-consecutive-patients-treated-with-transcatheter-aortic-valve-implantation-and-propensity-score-matched-analysis-of-early-versus-new-generation-valves
#4
Amos Levi, Uri Landes, Abid R Assali, Katia Orvin, Ram Sharony, Hanna Vaknin-Assa, Ashraf Hamdan, Yaron Shapira, Shmuel Schwartzenberg, Pablo Codner, Aviv A Shaul, Mordechai Vaturi, Ariel Gutstein, Alexander Sagie, Ran Kornowski
Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in patients at high or prohibitive surgical risk. Nevertheless, long-term clinical and echocardiographic data are still lacking. We carried out an analysis of 560 consecutive patients who underwent TAVI at our institution from 2008 to 2016 to evaluate temporal changes in TAVI characteristics, predictors of 1-year and long-term outcomes, and to compare the performance of the early- and new-generation valve systems...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28355345/chronic-dosing-with-mirtazapine-does-not-produce-sedation-in-rats
#5
Alberto Salazar-Juárez, Susana Barbosa-Méndez, Paola Merino-Reyes, Maura Matus-Ortega, Jorge A Hernández-Calderón, Benito Antón
OBJECTIVE: Sedation/somnolence are major side effects of pharmacotherapies for depression, and negatively affect long-term treatment compliance in depressed patients. Use of mirtazapine (MIR), an atypical antidepressant approved for the treatment of moderate to severe depression with comorbid anxiety disorders, is associated with significant sedation/somnolence, especially in short-term therapy. Nonetheless, studies with human subjects suggest that MIR-induced sedation is transient, especially when high and repeated doses are used...
March 23, 2017: Revista Brasileira de Psiquiatria
https://www.readbyqxmd.com/read/28345549/sub-anesthesia-dose-of-isoflurane-in-60-oxygen-reduces-inflammatory-responses-in-experimental-sepsis-models
#6
Yi Huang, Xiao-Xia Wang, Dong-Dong Sun, Ze-Xin Zhang, Wan-Wan Yang, Tian Shao, Han Han, Er-Fei Zhang, Zhong-Shu Pu, Zuo-Xu Hou, Hai-Long Dong, Li-Ze Xiong, Li-Chao Hou
BACKGROUND: Sepsis is a major cause of mortality in Intensive Care Units. Anesthetic dose isoflurane and 100% oxygen were proved to be beneficial in sepsis; however, their application in septic patients is limited because long-term hyperoxia may induce oxygen toxicity and anesthetic dose isoflurane has potential adverse consequences. This study was scheduled to find the optimal combination of isoflurane and oxygen in protecting experimental sepsis and its mechanisms. METHODS: The effects of combined therapy with isoflurane and oxygen on lung injury and sepsis were determined in animal models of sepsis induced by cecal ligation and puncture (CLP) or intraperitoneal injection of lipopolysaccharide (LPS) or zymosan...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28342959/early-lance-adams-syndrome-after-cardiac-arrest-prevalence-time-to-return-to-awareness-and-outcome-in-a-large-cohort
#7
Irene Aicua Rapun, Jan Novy, Daria Solari, Mauro Oddo, Andrea O Rossetti
INTRODUCTION: Early myoclonus after cardiac arrest (CA) is traditionally viewed as a poor prognostic sign (status myoclonus). However, some patients may present early Lance-Adams syndrome (LAS): under appropriate treatment, they can reach a satisfactory functional outcome. Our aim was to describe their profile, focusing on pharmacologic management in the ICU, time to return of awareness, and long-term prognosis. METHODS: Adults with early LAS (defined as generalized myoclonus within 96h, with epileptiform EEG within 48h after CA) were retrospectively identified in our CA registry between 2006 and 2016...
March 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#8
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28300462/an-update-on-the-advancements-in-the-treatment-of-agitation-in-alzheimer-s-disease
#9
REVIEW
Anton P Porsteinsson, Inga M Antonsdottir
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks safe and effective long term interventions. Nonpharmacological interventions are suggested as first-line treatment, but aren't effective for every patient, resulting in pharmacological interventions for some patients, consisting of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where efficacy doesn't necessarily outweigh associated risks...
April 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#10
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28267008/endoscopic-pilonidal-sinus-treatment-combined-with-crystalized-phenol-application-may-prevent-recurrence
#11
Ibrahim Ethem Gecim, Utku Ufuk Goktug, Haydar Celasin
BACKGROUND: No single treatment yet exists for pilonidal disease that has a short healing time, good cosmetic results, and a low rate of recurrence. Phenol crystal application and diathermy ablation through an endoscope have been used for the treatment of pilonidal disease, but this cohort is the first one to combine them. OBJECTIVE: The purpose of this study was to examine the safety, effectiveness, and short- and long-term outcomes of crystalized phenol treatment combined with endoscopic pilonidal sinus treatment for pilonidal disease...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28262515/integrated-primary-care-insomnia-management-in-australia
#12
Fatema-Tun-Naher Sake, Keith Wong, Delwyn J Bartlett, Bandana Saini
BACKGROUND: There is growing support to expand the roles of pharmacists by recognizing their knowledge and skills beyond those around dispensing of medications. Introducing non-dispensing pharmacists at the premises of General Practitioners (GPs) for a collaborative service can potentially and significantly help to provide more effective and efficient health services, for example, in under-recognized or mismanaged conditions such as insomnia. Such a collaborative service could also reduce the costs and risks associated with long-term use of sedatives, besides improving patient's quality of life...
February 20, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28260438/results-of-biliary-reconstruction-using-a-polytetrafluoroethylene-graft-in-liver-transplant-patients
#13
Mehmet Haberal, Ebru H Ayvazoglu Soy, Gokhan Moray, Kenan Caliskan, Sedat Yildirim, Adnan Torgay
OBJECTIVES: Biliary complications after liver transplant are a major concern with their high incidence, the need for repeated and long-term treatment, and their potential effects on graft and patient survival. We report our experience with biliary anastomosis using a spiral polytetrafluoroethylene graft. MATERIALS AND METHODS: Between December 8, 1988, and July 2016, we performed 538 liver transplant procedures. We used a spiral polytetrafluoroethylene graft for biliary anastomosis in 10 patients: for biliary stricture reconstruction after liver transplant in 4 patients and during the primary liver transplant in 6 patients...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260190/general-anesthesia-improves-contact-force-and-reduces-gap-formation-in-pulmonary-vein-isolation-a-comparison-with-conscious-sedation
#14
Akio Chikata, Takeshi Kato, Takanori Yaegashi, Satoru Sakagami, Chieko Kato, Takahiro Saeki, Keiichi Kawai, Shin-Ichiro Takashima, Hisayoshi Murai, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
Compared to conscious sedation (CS), the use of general anesthesia (GA) in pulmonary vein isolation (PVI) is associated with a lower recurrence rate of atrial fibrillation (AF). GA may improve catheter stability and mapping system accuracy compared to CS, but its influence on contact force (CF) parameters during ipsilateral PVI has not previously been investigated. The study population comprised 176 consecutive patients (107 in GA group and 69 in CS group) with AF who underwent their first PVI procedure. We retrospectively assessed CF parameters, force-time integral (FTI), FTI/wall thickness during anatomical ipsilateral PVI and long-term outcome after ablation...
March 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#15
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28240945/evaluation-of-contractile-phenotype-in-airway-smooth-muscle-cells-isolated-from-endobronchial-biopsy-and-tissue-specimens-from-horses
#16
Amandine Vargas, Aude Peltier, Jean Dubé, Josiane Lefebvre-Lavoie, Véronique Moulin, Francine Goulet, Jean-Pierre Lavoie
OBJECTIVE To develop a method to maintain the initial phenotype of airway smooth muscle (ASM) cells isolated from equine endobronchial biopsy specimens in long-term cell culture. SAMPLE Endobronchial tissue specimens (8 to 10/horse) collected from the lungs of previously healthy horses at necropsy (n = 12) and endobronchial biopsy specimens collected from standing, sedated, heaves-affected horses in clinical remission of the disease (5) and control horses (4). PROCEDURES A sampling protocol was developed to recover and maintain a contractile phenotype in ASM cells from endobronchial specimens from freshly harvested equine lungs and from healthy and heaves-affected horses...
March 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28236389/early-mobilization-of-mechanically-ventilated-patients
#17
REVIEW
Pam Hruska
Critically ill patients requiring mechanical ventilation are least likely to be mobilized and, as a result, are at-risk for prolonged complications from weakness. The use of bed rest and sedation when caring for mechanically ventilated patients is likely shaped by historical practice; however, this review demonstrates early mobilization, with little to no sedation, is possible and safe. Assessing readiness for mobilization in context of progressing patients from passive to active activities can lead to long-term benefits and has been achievable with resource-efficient implementations and team work...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28222534/a-meta-analysis-of-memantine-for%C3%A2-depression
#18
Taro Kishi, Shinji Matsunaga, Nakao Iwata
We conducted a systematic review and meta-analysis on whether memantine was beneficial for the treatment of depressive symptoms in major depressive disorder (MDD) and bipolar disorder (BD). The analysis included double-blind, randomized, placebo-controlled trials of memantine in MDD and BD. The primary outcome measures for efficacy and safety were response rate and all-cause discontinuation, respectively. Risk ratio (RR) and standardized mean difference with 95% confidence intervals (95% CI) were calculated...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#19
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28206874/a-quality-improvement-initiative-on-the-use-of-psychotropic-drugs-in-nursing-homes-in-flanders
#20
Majda Azermai, Maarten Wauters, Dirk De Meester, Lisa Renson, Danny Pauwels, Laurine Peeters, Hans Warie, Mirko Petrovic
INTRODUCTION: Government-funded quality improvement projects aimed to reduce the high psychotropic medication use in Belgian long-term care settings. DESIGN: A pilot project (2013-2014) with a pre-post and follow-up intervention design. METHODS: Two nursing homes received three educational courses. In the intervention nursing home (INH) additionally, a transition towards person-centred care through professional support was applied. Drug use was recorded at baseline, after 10 months (post) and after 22 months (follow-up), and coded into the Anatomical Therapeutic Chemical classification...
February 16, 2017: Acta Clinica Belgica
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