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https://www.readbyqxmd.com/read/29752134/modifying-institutional-guidelines-reduces-the-likelihood-of-oversedation-during-interventional-procedures
#1
Jonathan G Martin, Zachary L Bercu, Lauren Becker, Morgan Whitmore, Jay Shah, Daryl Goldman, Janice Newsome
No abstract text is available yet for this article.
May 8, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29750696/patient-controlled-versus-clinician-controlled-sedation-with-propofol-systematic-review-and-meta-analysis-with-trial-sequential-analyses
#2
Lukas Kreienbühl, Nadia Elia, Elvire Pfeil-Beun, Bernhard Walder, Martin R Tramèr
BACKGROUND: Sedation with propofol is frequently used to facilitate diagnostic and therapeutic procedures. Propofol can be administrated by the patient (patient-controlled sedation [PCS]) or by a clinician (clinician-controlled sedation [CCS]). We aimed to compare these 2 techniques. METHODS: PubMed, Embase, CENTRAL, and trial registries were searched up to October 2017 for randomized controlled trials comparing PCS with CCS with propofol. The primary end points were the risks of presenting at least 1 episode of oxygen desaturation, arterial hypotension, and bradycardia, and the risk of requiring a rescue intervention (pharmacologic therapies or physical maneuvers) for sedation-related adverse events...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29739132/assessment-of-switching-to-suvorexant-versus-the-use-of-add-on-suvorexant-in-combination-with-benzodiazepine-receptor-agonists-in-insomnia-patients-a-retrospective-study
#3
Masakazu Hatano, Hiroyuki Kamei, Risa Inagaki, Haruna Matsuzaki, Manako Hanya, Shigeki Yamada, Nakao Iwata
Objective: Suvorexant is a novel hypnotic drug that does not interact with the conventional γ-aminobutyric acid (GABA)-A receptor. We investigated the method by which suvorexant was introduced in insomnia patients who were taking benzodiazepine receptor agonists (BzRA). Methods: This was a retrospective study. We extracted clinical data for patients who were prescribed suvorexant and were already using BzRA. The patients were assigned to two groups, the switching and add-on groups...
May 31, 2018: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29729659/improving-health-care-for-critically-ill-patients-using-an-evidence-based-collaborative-approach-to-abcdef-bundle-dissemination-and-implementation
#4
Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29702358/a-medicolegal-analysis-of-malpractice-claims-involving-anesthesiologists-in-the-gastrointestinal-endoscopy-suite-2007-2016
#5
Alexander B Stone, Ethan Y Brovman, Penny Greenberg, Richard D Urman
STUDY OBJECTIVE: Gastrointestinal endoscopy cases make up the largest portion of out of operating room malpractice claims involving anesthesiologists. To date, there has been no closed claims analysis specifically focusing on the claims from the endoscopy suite. We aim to identify associated case characteristics and contributing factors. DESIGN: Retrospective review of closed claims. SETTING: Multi-institutional setting of hospitals that submit data to the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System, a database representing approximately 30% of annual malpractice cases in the United States...
April 24, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29575232/the-impact-of-narcotrend%C3%A2-eeg-guided-propofol-administration-on-the-speed-of-recovery-from-pediatric-procedural-sedation-a-randomized-controlled-trial
#6
Frank Weber, Laurence C Walhout, Johanna C Escher
BACKGROUND: Propofol is often used for procedural sedation in children undergoing gastrointestinal endoscopy. Reliable assessment of the depth of hypnosis during the endoscopic procedure is challenging. Processed electroencephalography using the Narcotrend Index can help titrating propofol to a predefined sedation level. AIMS: The aim of this trial was to investigate the impact of Narcotrend Index-guided titration of propofol delivery on the speed of recovery. METHODS: Children, aged 12-17 years, undergoing gastrointestinal endoscopy under procedural sedation, had propofol delivered via target controlled infusion either based on Narcotrend Index guidance (group NI) or standard clinical parameters (group C)...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29570859/oral-lorazepam-can-be-substituted-for-intravenous-midazolam-when-weaning-paediatric-intensive-care-patients-off-sedation
#7
Anna C van der Vossen, Merel van Nuland, Erwin G Ista, Saskia N de Wildt, Lidwien M Hanff
AIM: Intravenous sedatives used in the paediatric intensive care unit (PICU) need to be tapered after prolonged use to prevent iatrogenic withdrawal syndrome (IWS). We evaluated the occurrence of IWS and the levels of sedation before and after conversion from intravenous midazolam to oral lorazepam. METHODS: This was a retrospective, observational, single cohort study of children under the age of 18 admitted to the PICU of the Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands, between January 2013 and December 2014...
March 23, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29509567/immunomodulatory-effects-of-fentanyl-or-dexmedetomidine-hydrochloride-infusion-after-allogeneic-heart-transplantation-in-mice
#8
Weili Chen, Ning Jin, Yingying Lin, Vincenzo Villani, Akira Shimizu, Xia Zhao, FangNa Lu, Cheng Li, KeGong Chen, Zhi Lin, Zhongquan Qi
BACKGROUND AND OBJECTIVES: Postoperatively, transplant recipients receive immunosuppressants, as well as sedatives and analgesics. The immunomodulatory effects of these other agents during the induction period following transplantation remain unclear. We aimed to determine whether the agents dexmedetomidine hydrochloride (Dex) and fentanyl (Fen) have immunomodulatory effects during the induction period following heart transplantation (HTx). METHODS: Fifty mice were used for antinociception tests after administration of Dex and Fen, and T cells from 3 naive animals were used for in vitro lymphocyte transformation test (study 1)...
March 5, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29411034/oversedation-of-a-patient-with-obstructive-sleep-apnea-prior-to-imaging
#9
Eddie Blay, Cynthia Barnard, Karl Y Bilimoria
No abstract text is available yet for this article.
February 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29361326/evidence-based-review-of-pharmacotherapy-for-acute-agitation-part-1-onset-of-efficacy
#10
Leslie S Zun
BACKGROUND: The main goal of antipsychotic medication in the management of acute agitation in the emergency department is to rapidly induce calm without oversedation, enabling patients to participate in their own care. However, there is a paucity of comparative studies, particularly with newer fast-acting second-generation antipsychotic agents. OBJECTIVE OF THE REVIEW: This structured evidence-based review compared the onset of efficacy of antipsychotic treatments for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
March 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29357776/comparison-of-lurasidone-versus-quetiapine-for-the-treatment-of-delirium-in-critically-ill-patients
#11
Marlena A Fox, Jessica L Elefritz, Brandon M Huang, Charles Hunley
OBJECTIVE: To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients. DESIGN: Prospective, observational cohort study. SETTING: Single-center community teaching hospital. PATIENTS: Forty adult intensive care unit (ICU) patients with delirium (Confusion Assessment Method in the ICU positive), tolerating enteral nutrition, and without active alcohol withdrawal or prior use of atypical antipsychotics...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29333613/pharmacokinetics-pharmacodynamics-and-clinical-use-of-trazodone-and-its-active-metabolite-m-chlorophenylpiperazine-in-the-horse
#12
J L Davis, J Schirmer, E Medlin
Trazodone is a serotonin receptor antagonist and reuptake inhibitor used extensively as an anxiolytic in human and small animal veterinary medicine. The aims of this study were to determine the pharmacokinetics of oral trazodone in experimental horses and to evaluate the effect of oral trazodone in clinical horses. Six experimental horses were administered trazodone at 7.5 or 10 mg/kg. Plasma concentrations of trazodone and its metabolite (m-CPP) were determined via UPLC-MS/MS. Noncompartmental pharmacokinetic analysis, sedation and ataxia scores were determined...
January 14, 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29180889/risk-of-respiratory-depression-with-opioids-and-concomitant-gabapentinoids
#13
Julie Savelloni, Heather Gunter, Kelly C Lee, Chih Hsu, Cassia Yi, Kyle P Edmonds, Timothy Furnish, Rabia S Atayee
Introduction: The combination of opioids and central nervous system depressants such as benzodiazepines and barbiturates has an additive effect on the frequency of oversedation and respiratory depression requiring naloxone use in hospitalized patients. Gabapentinoids (gabapentin and pregabalin) are frequently prescribed with opioids for their opioid-sparing and adjuvant analgesic effects. There is limited literature on the risk of respiratory depression due to the combination of opioids and gabapentinoids requiring naloxone administration...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918427/safety-of-monitored-anesthesia-care-using-propofol-based-sedation-for-pleuroscopy
#14
Erik Vakil, Mona Sarkiss, David Ost, Macarena R Vial, Roberto F Casal, Georgie A Eapen, Horiana B Grosu
BACKGROUND: The optimal approach to sedation for pleuroscopy remains undefined. Propofol is the favored sedative-hypnotic for many proceduralists but has a narrow therapeutic window and the risk for oversedation is high. Propofol-based sedation administered by anesthesiologists and the routine use of end-tidal capnography and bispectral index (BIS) monitoring may attenuate risks of complications. OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of monitored anesthesia care for pleuroscopy...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28864434/psychotropic-drug-use-in-physically-restrained-critically-ill-adults-receiving-mechanical-ventilation
#15
Melanie Guenette, Lisa Burry, Alexandra Cheung, Tara Farquharson, Marlene Traille, Ioanna Mantas, Sangeeta Mehta, Louise Rose
BACKGROUND: Restraining therapies (physical or pharmacological) are used to promote the safety of both patients and health care workers. Some guidelines recommend nonpharmacological or pharmacological interventions be used before physical restraints in critically ill patients. OBJECTIVES: To characterize psychotropic drug interventions before and after use of physical restraints in critically ill adults receiving mechanical ventilation. METHODS: A single-center, prospective, observational study documenting psychotropic drug use and Sedation-Agitation Scale (SAS) scores in the 2 hours before and the 6 hours after application of physical restraints...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28791566/effects-of-antidepressants-on-sleep
#16
REVIEW
Adam Wichniak, Aleksandra Wierzbicka, Małgorzata Walęcka, Wojciech Jernajczyk
PURPOSE OF REVIEW: The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. RECENT FINDINGS: Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder...
August 9, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28703949/psychotherapy-alone-and-combined-with-medication-as-treatments-for-bipolar-ii-depression-a-randomized-controlled-trial
#17
Holly A Swartz, Paola Rucci, Michael E Thase, Meredith Wallace, Elisa Carretta, Karen L Celedonia, Ellen Frank
OBJECTIVE: Bipolar II disorder (BP-II) is associated with marked morbidity and mortality. Quetiapine, the treatment with greatest evidence for efficacy in BP-II depression, is associated with metabolic burden. Psychotherapy, a treatment with few side effects, has not been systematically evaluated in BP-II. This study compared psychotherapy plus placebo to psychotherapy plus pharmacotherapy as treatments for BP-II depression. METHODS: From 2010 to 2015, unmedicated adults (n = 92) with DSM-IV-TR BP-II depression were randomly assigned to weekly sessions of Interpersonal and Social Rhythm Therapy (IPSRT) plus placebo or IPSRT plus quetiapine and followed for 20 weeks...
March 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28594450/evaluation-of-the-effectiveness-of-two-morphine-protocols-to-treat-neonatal-abstinence-syndrome-in-a-level-ii-nursery-in-a-community-hospital
#18
Heather N DeAtley, Amanda Burton, Michelle DeLuca Fraley, Joan Haltom
The authors sought to evaluate the impact on length of hospital stay and treatment duration of morphine after implementation of a change in the institutional protocol for managing neonatal abstinence syndrome (NAS) in an effort to improve patient outcomes. A single-center, retrospective chart review was conducted at a Level II nursery in a community hospital in Kentucky. Fifty-nine neonates born between January 1, 2014, and December 31, 2015, who were diagnosed with NAS and received morphine for treatment were included...
June 8, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28412050/-the-correlation-among-the-ramsay-sedation-scale-richmond-agitation-sedation-scale-and-riker-sedation-agitation-scale-during-midazolam-remifentanil-sedation
#19
Turgut Namigar, Karacalar Serap, Akdaş Tekin Esra, Odacılar Özgül, Öztürk Ali Can, Ak Aysel, Ali Achmet
BACKGROUND AND OBJECTIVES: Sedative and analgesic treatment administered to critically ill patients need to be regularly assessed to ensure that previously stated goals are well achieved as the risk of complications of oversedation is minimized. We revised and prospectively tested the Ramsay Sedation Scale (RSS) for interrater reliability and compared it with the Riker Sedation-Agitation Scale (RSAS) and the Richmond Agitation Sedation Scale (RASS) to test construct validity during midazolam-remifentanil sedation...
July 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28368918/evaluating-the-effectiveness-of-end-tidal-carbon-dioxide-monitoring-during-burn-wound-care-in-the-nonintubated-patient-population
#20
Samantha Weimer, Justin Burleson, Mary Mancuso, Cameron Bell, Mary Beth Flynn Makic
Daily burn wound care for nonintubated patients involves administration of intravenous analgesic and sedation agents. Vital signs and oxygen saturation monitoring alone can result in late signs of oversedation and ineffective breathing. End-tidal carbon dioxide (EtCo2) monitoring provides immediate feedback of effective breathing during procedural sedation. The purpose of this study was to describe the nurse's sedation and analgesic therapy management of nonintubated patients during burn wound care when EtCo2 was used...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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