Read by QxMD icon Read

RASS score

Ahmed Hasanin, Sabah Abdel Raouf Mohamed, Akram El-Adawy
Pain is a common and undertreated problem in critically ill patients. Pain assessment in critically ill patients is challenging and relies on complex scoring systems. The aim of this work was to find out the possible role of the perfusion index (PI) measured by a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, USA) in pain assessment in critically ill patients. A prospective observational study was carried out on 87 sedated non-intubated patients in a surgical intensive care unit. In addition to routine monitoring, a Masimo pulse oximeter probe was used for PI measurement...
September 24, 2016: Journal of Clinical Monitoring and Computing
Stephen S Humble, Laura D Wilson, Taylor C Leath, Matthew D Marshall, Daniel Z Sun, Pratik P Pandharipande, Mayur B Patel
OBJECTIVE: To comprehensively describe the use of dexmedetomidine in a single institutional series of adult ICU patients with severe TBI. This study describes the dexmedetomidine dosage and infusion times, as well as the physiological parameters, neurological status and daily narcotic requirements before, during and after dexmedetomidine infusion. METHODS: This study identified 85 adult patients with severe TBI who received dexmedetomidine infusions in the Trauma ICU at Vanderbilt University Medical Center between 2006-2010...
2016: Brain Injury: [BI]
Sebastian Stukenberg, Martin Franck, Claudia D Spies, Bruno Neuner, Isaac Myers, Finn M Radtke
BACKGROUND: Postoperative impairment of the cerebral function can appear immediately after general anesthesia and may be predictive for a postoperative delirium. We compared three tools assessing patients on recovery room admission in order to detect early signs of postoperative brain dysfunction: the Postanesthetic Recovery Score (PARS), the Richmond Agitation-Sedation Scale (RASS) and the Nursing Delirium Screening Scale (Nu-DESC). METHODS: Inclusion criteria of this secondary analysis of the randomized SuDoCo trial were: age ≥60 years, schedule for elective non-cardiac surgery with an anticipated duration of ≥60 minutes, general anesthesia, ability to communicate in German language...
July 2016: Minerva Anestesiologica
Stephanie Godard, Christophe Herry, Paul Westergaard, Nathan Scales, Samuel M Brown, Karen Burns, Sangeeta Mehta, Frank J Jacono, Dalibor Kubelik, Donna E Maziak, John Marshall, Claudio Martin, Andrew J E Seely
Background. Spontaneous breathing trials (SBTs) are standard of care in assessing extubation readiness; however, there are no universally accepted guidelines regarding their precise performance and reporting. Objective. To investigate variability in SBT practice across centres. Methods. Data from 680 patients undergoing 931 SBTs from eight North American centres from the Weaning and Variability Evaluation (WAVE) observational study were examined. SBT performance was analyzed with respect to ventilatory support, oxygen requirements, and sedation level using the Richmond Agitation Scale Score (RASS)...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Chelsea L Tasaka, Jeremiah J Duby, Komal Pandya, Machelle D Wilson, Kimberly A Hardin
BACKGROUND: Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BIS™) provides an objective measure of sedation; however, the role of BIS™ is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA). OBJECTIVE: The aim of this study was to delineate the relationship between BIS™ and level of sedation for critically ill patients during therapeutic paralysis...
June 2016: Drugs—Real World Outcomes
Rikke Rass Winkel, My von Euler-Chelpin, Mads Nielsen, Kersten Petersen, Martin Lillholm, Michael Bachmann Nielsen, Elsebeth Lynge, Wei Yao Uldall, Ilse Vejborg
BACKGROUND: Mammographic density is a well-established risk factor for breast cancer. We investigated the association between three different methods of measuring density or parenchymal pattern/texture on digitized film-based mammograms, and examined to what extent textural features independently and jointly with density can improve the ability to identify screening women at increased risk of breast cancer. METHODS: The study included 121 cases and 259 age- and time matched controls based on a cohort of 14,736 women with negative screening mammograms from a population-based screening programme in Denmark in 2007 (followed until 31 December 2010)...
2016: BMC Cancer
Giorgio Conti, Vito Marco Ranieri, Roberta Costa, Chris Garratt, Andrew Wighton, Giorgia Spinazzola, Rosario Urbino, Luciana Mascia, Giuliano Ferrone, Pasi Pohjanjousi, Gabriela Ferreyra, Massimo Antonelli
BACKGROUND: Dexmedetomidine can be used for sedation of mechanically ventilated patients and has minor respiratory effects. The aim of this study was to compare the incidence of patient-ventilator dyssynchronies during sedation with dexmedetomidine or propofol. METHODS: We conducted a multicentre, prospective, open-label, randomised clinical trial, comparing dexmedetomidine with standard propofol sedation at three intensive care units of university hospitals in Italy...
July 2, 2016: Critical Care: the Official Journal of the Critical Care Forum
Alessandro Morandi, Jin H Han, David Meagher, Eduard Vasilevskis, Joaquim Cerejeira, Wolfgang Hasemann, Alasdair M J MacLullich, Giorgio Annoni, Marco Trabucchi, Giuseppe Bellelli
OBJECTIVES: Delirium disproportionately affects patients with dementia and is associated with adverse outcomes. The diagnosis of delirium superimposed on dementia (DSD), however, can be challenging due to several factors, including the absence of caregivers or the severity of preexisting cognitive impairment. Altered level of consciousness has been advocated as a possible useful indicator of delirium in this population. Here we evaluated the performance of the Richmond Agitation and Sedation Scale (RASS) and the modified-RASS (m-RASS), an ultra-brief measure of the level of consciousness, in the diagnosis of DSD...
September 1, 2016: Journal of the American Medical Directors Association
Brianne M Ritchie, Heather Torbic, Jeremy R DeGrado, David P Reardon
BACKGROUND: Variability in sedation may increase the incidence of delirium and mortality, as well as increased intensive care unit (ICU) and hospital lengths of stay (LOS), despite mean Richmond Agitation Sedation Scale (RASS) scores at goal. Coefficient of variation (CV) can be used to represent variability with a higher ratio indicating increased variability. STUDY QUESTION: Do patients with an increased variability in sedation, as evaluated by CV in RASS, have an increased incidence of delirium? METHODS: We conducted a retrospective chart review of adult medical ICU patients requiring mechanical ventilation (MV) for ≥24 hours between January and April 2013...
June 23, 2016: American Journal of Therapeutics
Xing Lu, Jun Li, Tong Li, Jie Zhang, Zhi-Bo Li, Xin-Jing Gao, Lei Xu
PURPOSE: To evaluate midazolam sequential with dexmedetomidine for agitated patients undergoing weaning to implement light sedation in ICU. METHODS: This randomized, prospective study was conducted in Tianjin Third Central Hospital, China. Using a sealed-envelope method, the patients were randomly divided into 2 groups (40 patients per group). Each patient of group A received an initial loading dose of midazolam at 0.3-3mg/kg·h 24 h before extubation, followed by an infusion of dexmedetomidine at a rate of 0...
April 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Ruixia Song, Junyan Li, Chenming Dong, Jing Yang
OBJECTIVE: To compare the sedative effect and safety of dexmedetomidine and midazolam in the intensive care unit (ICU) patients undergoing ventilator bundle treatment. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Ninety patients receiving ICU ventilator-assisted therapy and ventilator bundle treatments for more than 3 days in the First Department of Critical Care Medicine of the Second Hospital of Lanzhou University from January 2013 to December 2014 were enrolled...
October 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chika Ishibashi, Masakazu Hayashida, Yusuke Sugasawa, Keisuke Yamaguchi, Natsumi Tomita, Yoshiaki Kajiyama, Eiichi Inada
PURPOSE: We evaluated the hemodynamic and respiratory effects of dexmedetomidine in intubated, spontaneously breathing patients after endoscopic submucosal dissection (ESD) for cervical esophageal or pharyngeal cancer. METHODS: This retrospective study included 129 patients aged 66.5 ± 8.3 years, who underwent ESD under general anesthesia, and who were kept intubated overnight to prevent airway obstruction, receiving sedation with dexmedetomidine. Constant dexmedetomidine infusion at 0...
August 2016: Journal of Anesthesia
Catherine K Floroff, Tanna B Hassig, Joel B Cochran, Joseph E Mazur
Use of ketamine in patients requiring extracorporeal membrane oxygenation (ECMO) has rarely been reported, and the optimal dosing strategy remains unclear. A patient admitted with hypoxic respiratory failure required ECMO in addition to continuous infusion of low-dose ketamine following titration of opioid and sedative medications to high doses. After initiation of ketamine, infusion rates of opioids and/or sedatives were maintained or decreased. Recorded Richmond Agitation-Sedation Scale (RASS) scores were -4 to -5 and documented pain scores were 0...
2016: Journal of Pain & Palliative Care Pharmacotherapy
Junyan Li, Chenming Dong, Hong Zhang, Hongsong Zhang, Ruixia Song, Zhaohui Yang, Fang Feng, Yan Qi, Jing Yang
OBJECTIVE: To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). METHODS: A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled...
January 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Hojatollah Yousefi, Farzaneh Toghyani, Ahmad Reza Yazdannik, Kamran Fazel
BACKGROUND: Mechanical ventilation is one of the supporting treatments that are used for different reasons. To reduce patients' inconvenience caused due to using tracheal tube and ventilator, sedation is routinely used. Using scales for the sedation, for example, Richmond Agitation Sedation Scale (RASS), may reduce dose of sedation and length of mechanical ventilation. MATERIALS AND METHODS: This study is a randomized clinical trial on 64 patients selected from three intensive care units (ICUs) in Isfahan, Iran...
November 2015: Iranian Journal of Nursing and Midwifery Research
Sebastian Stukenberg, Martin Franck, Claudia Doris Spies, Bruno Neuner, Isaac Myers, Finn Michael Radtke
BACKGROUND: Postoperative impairment of the cerebral function can appear immediately after general anesthesia and may be predictive for a postoperative delirium. We compared three tools assessing patients on recovery room admission in order to detect early signs of postoperative brain dysfunction: the Postanesthetic Recovery Score (PARS), the Richmond Agitation-Sedation Scale (RASS) and the Nursing Delirium Screening Scale (Nu-DESC). METHODS: Inclusion criteria of this secondary analysis of the randomized SuDoCo trial were: age ≥ 60 years, schedule for elective non-cardiac surgery with an anticipated duration of ≥ 60 minutes, general anesthesia, ability to communicate in German language...
January 8, 2016: Minerva Anestesiologica
Christine Jungk
Analgesia and sedation of patients in the neuro intensive care unit, in particular in case of intracranial hypertension, remains a challenge even today. A goal for analgesia and sedation should be set for each individual patient (RASS -5 in case of intracranial hypertension) and should be re-evaluated repeatedly based on standardized scores (RASS plus EEG monitoring where appropriate, NCS). There are no sufficient evidence-based sedation algorithms in this patient cohort. Remifentanil, sufentanil and fentanyl have been proven safe and effective for continuous application; however, bolus application should be avoided...
November 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
LeeAnna Spiva, Patricia L Hart, Erin Gallagher, Frank McVay, Melida Garcia, Karen Malley, Marsha Kadner, Angela Segars, Betsy Brakovich, Sonja Y Horton, Novlette Smith
The study purpose was to assess the effects of guided imagery on sedation levels, sedative and analgesic volume consumption, and physiological responses of patients being weaned from mechanical ventilation. Forty-two patients were selected from two community acute care hospitals. One hospital served as the comparison group and provided routine care (no intervention) while the other hospital provided the guided imagery intervention. The intervention included two sessions, each lasting 60 minutes, offered during morning weaning trials from mechanical ventilation...
2015: Evidence-based Complementary and Alternative Medicine: ECAM
Giuseppe Bellelli, Andrea Mazzone, Alessandro Morandi, Nicola Latronico, Sabrina Perego, Sara Zazzetta, Paolo Mazzola, Giorgio Annoni
OBJECTIVE: Impaired arousal is associated with negative outcomes in intensive care units, but studies in acute medical wards are scanty. The study aim was to evaluate the association between impaired arousal, as measured using an ultrabrief screen, and risk of both 1- and 6-month mortality and discharge to nursing home (NH) or hospice. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: An acute geriatric unit (AGU) of a university-based hospital in Northern Italy...
March 1, 2016: Journal of the American Medical Directors Association
Andrea Schmitz, Christian Schulz, Uta Friebel, Thomas Hohlfeld, Claudia Bausewein
CONTEXT: Breathlessness is one of the most distressing symptoms experienced by patients with advanced cancer and noncancer diagnoses alike. Often, severity of breathlessness increases quickly, calling for rapid symptom control. Oral, buccal, and parenteral routes of provider-controlled drug administration have been described. It is unclear whether patient-controlled therapy (PCT) systems would be an additional treatment option. OBJECTIVES: To investigate whether intravenous opioid PCT can be an effective therapeutic method to reduce breathlessness in patients with advanced disease...
March 2016: Journal of Pain and Symptom Management
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"