Eye care in sedated patients

BACKGROUND: To investigate the characteristics of sleep cycle in children with severe acute bronchopneumonia treated with invasive mechanical ventilation at different sedation depths. METHODS: We included 35 pediatric patients with severe acute bronchopneumonia treated using mechanical ventilation in Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University. They were divided into deep sedation group (n = 21; ramsay score 5-6) and light sedation group (n = 14; ramsay score3-4) based on sedation depth achieved during mechanical ventilation...

INTRODUCTION: Endoscopic Endonasal Dacryocystorhinostomy (EENDCR) is effective, safe and less time consuming procedure and scar free to manage patients with epiphora. Traditionally, EENDCR is performed under general anesthesia. Limited general anesthesia facility in our country has made EENDCR surgery limited to the hospitals with GA facilities. EENDCR surgery under local or assisted local anesthesia could be an alternative solution. The aim of the study was to study the pain tolerability of the patient undergoing EENDCR under local anesthesia (LA) or assisted local anesthesia (ALA)...

PURPOSE: To systematically review sleep evaluation, characterize sleep disruption, and explore effects of sleepdisruption on outcomes in adult ICU patients. MATERIALS AND METHODS: We systematically searched databases from May 1969 to June 2021 (PROSPERO protocol number: CRD42020175581). Prospective and retrospective studies were included studying sleep in critically ill adults, excluding patients with sleep or psychiatric disorders. Meta-regression methods were applied when feasible...

INTRODUCTION: Pupillometry allows for a standardized assessment of the pupillary light reflex. Acute hydrocephalus (HCP) is a common complication in patients with aneurysmal subarachnoid hemorrhage (aSAH). HCP may affect the pupillary light reflex because of increased intracranial pressure or dilation of the rostral aqueduct. The association between the pupillary light reflex and HCP in aSAH patients has not been clearly established. The objective of this study is to analyze the correlation between the Neurological Pupil index (NPi) and the degree of HCP in aSAH patients...

AIM: The study aimed to examine pain behavior during nursing interventions in patients who were on mechanical ventilation. METHOD: The study was carried out in patients who were under treatment at a university hospital during the 2017-2018 period and who were connected to a mechanical ventilator and were unable to communicate verbally. In two intensive cares (n = 165), 568 pain assessments were made before and during nursing interventions (aspirating the respiratory tract, wound care, injection applications, bed bath, perineal care, mouth care, etc...

DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: A study was conducted using high-fidelity electronic health record (EHR)-based simulations with incorporated eye tracking to understand the workflow of critical care pharmacists within the EHR, with specific attention to the data elements most frequently viewed...

PURPOSE: To determine the safety and efficacy of ketamine analgesia as an alternative to general anesthesia during laser treatment for retinopathy of prematurity (ROP). METHODS: Eighteen premature neonates with ROP underwent laser treatment. The procedure was performed in the operating room, and the neonates were admitted to the neonatal intensive care unit (NICU) after the procedure. An initial dose of 1 mg/kg of ketamine was administered. If the neonate exhibited movement or distress during the procedure, incremental doses of ketamine were administered...

Background: Electroencephalography (EEG) is widely used to monitor critically ill patients. However, EEG interpretation requires the presence of an experienced neurophysiologist and is time-consuming. Aim of this study was to evaluate whether parameters derived from an automated pupillometer (AP) might help to assess the degree of cerebral dysfunction in critically ill patients. Methods: Prospective study conducted in the Department of Intensive Care of Erasme University Hospital in Brussels, Belgium...

OBJECTIVE: There has been an increase in intensive care applications due to respiratory failure of COVID-19 infection. Management of respiratory failure includes a range of additional interventions, including high-flow nasal oxygen, noninvasive and invasive ventilation and prone position. These interventions contain risk factors for the development of ocular complications. This study aimed to elucidate the ocular pathologies that occurred in COVID-19 patients hospitalized in the intensive care unit...

PURPOSE: To describe a case where prophylactic use of nonsteroidal anti-inflammatory drugs (NSAID) eye drops lead to recurrent corneal melt with loss of vision and a brief literature review. METHODS: This is a case report of an 84-year-old diabetic female with chronic dry eye, operated by two different surgeons on each eye at different time intervals. She received topical NSAID prophylaxis after the second surgery only, which led to blindness due to recurrent corneal melt and chronic choroidal effusions...

Operating room (OR) noise contributes to team miscommunication. In facial plastic and reconstructive surgery (FPRS), many cases are completed under sedation. This creates a unique environment wherein patients are aware of OR noise. The objectives of this study were to quantify noise and evaluate team members' perspectives on communication inside of FPRS ORs. This study was completed across three surgical institutions. Objective noise measurements were recorded with SoundMeter X. A communication questionnaire was delivered to OR team members following each case...

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INTRODUCTION: Osteogenesis imperfecta (OI), a rare congenital disorder, has a risk of bone fracture and progressive bone deformity. OI type II is the most serious subtype, and very few reports on its anesthetic management exist. Patients face several anesthetic difficulties, of which easy fracturing of OI-affected bones is critical. Herein, we report our experience with the anesthetic management of a patient with OI type II. PATIENT CONCERNS AND DIAGNOSES: Through genetic testing, a 14-month-old girl (height: 45 cm, weight: 3...

INTRODUCTION: Sleep disorders are prevalent in patients with a neurocognitive disorder, and diagnosis and treatment in these patients remain challenging in clinical practice. METHODS: This narrative review offers a systematic approach to diagnose and treat sleep disorders in neurocognitive disorders. RESULTS: Alzheimer's disease is often associated with circadian rhythm disorders, chronic insomnia, and sleep apnea-hypopnea syndrome. Alpha-synucleinopathies (e...

In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients' severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care...

INTRODUCTION: In this prospective, randomised study, we compared the effects of the Macintosh, McGRATH MAC, and C-MAC laryngoscopes on intraocular pressure (IOP) and haemodynamics of non-ophthalmic patients during endotracheal intubation. METHODS: One hundred and twenty adult patients undergoing non-ophthalmic surgeries performed in the supine position under general anaesthesia requiring orotracheal intubation were included in this study. The patients were separated randomly and prospectively into 3 groups: Macintosh group (n = 40), McGRATH MAC group (n = 40), and C-MAC group (n = 40)...

Few existing cases of closed-eye visual hallucinations have been reported. These rare perceptual disturbances are distinct from open-eye visual hallucinations, as observed in Charles Bonnet syndrome. This case report discusses a 35-year-old male who presented with closed-eye visual hallucinations 24 hours before severe alcohol withdrawal. On initial presentation, the patient denied auditory or visual hallucinations. The day before the onset of severe alcohol withdrawal, the patient reported vivid, colorful, and lifelike visual hallucinations with his eyes closed which disappeared with eyes open...

BACKGROUND: To characterize pediatric dog bite injuries presenting to US children's hospitals and identify factors associated with clinically significant injuries. METHODS: We performed a multicenter observational study from 26 pediatric hospitals between July 1, 2010, and June 30, 2020, including patients ≤ 18 years with dog bites, consolidating together encounters from patients with multiple encounters within 30 days as a single episode of care. We characterized diagnoses and procedures performed in these patients...

INTRODUCTION: The aim of the study was to compare and evaluate the side effects (SEs) and sedation characteristics of synergistic sedation with doses of 0.25 μg kg-1 or 0.5 μg kg-1 intranasal (IN) sufentanil, and intravenous (IV) midazolam during propofol-based sedation in patients undergoing colonoscopy. MATERIAL AND METHODS: This was a prospective, randomized, double-blind study. The patients were randomly allocated into one of 3 groups: group I (n = 33) - sufentanil IN 0...

BACKGROUND: Superficial eye disorders are one of the most common complications of improper eye care in intensive care units that can lead to corneal ulcers and permanent eye damage. The aim of this study was to determine the effect of the implementation of eye care protocol on the incidence of infection and superficial eye disorders in patients admitted to intensive care units. METHODS: This study was a cross-over clinical trial that was performed on 32 patients admitted to the intensive care unit with reduced or no blink reflex following loss of consciousness or receiving sedatives...