OBJECTIVE Deep sedation and delirium are common in the ICU. Mechanically ventilated patients with acute lung injury are at especially high risk for deep sedation, delirium, and associated long-term physical and neuropsychiatric impairments. We undertook an ICU-wide structured quality improvement project to decrease sedation and delirium. DESIGN Prospective quality improvement project in compa...

BACKGROUND The present study aimed to elucidate the safety and effectiveness of a noble and unique airway management technique in which a pediatric intubation tube is used in adult patients with atrial fibrillation (AF) undergoing catheter ablation (CA) under continuous deep sedation. METHODS In total, 246 consecutive patients with AF (mean age, 65±10 years; 60 women) underwent CA under dexme...

INTRODUCTION As a result of the increased number of both diagnostic and therapeutic procedures in pediatric outpatients, sedation and analgesia have gained relevance in this context. OBJECTIVE To characterize the type of sedation and analgesia used by pediatric sedation teams in procedures done outside the operating room, as well as its safety and outcome. POPULATION AND METHODS All procedu...

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intelle...

ONE of the dilemmas faced by any caregiver providing sedation or anesthesia is the question, When is it safe to send the child home? Most sedation guidelines suggest that the patient should be returned to their baseline status before discharge. In this issue of the Journal, Malviya et al. describe a simple but elegant means for assessing the street readiness of infants sedated with chloral hydr...

Sedation is often necessary to optimize care for critically ill children requiring mechanical ventilation. If too light or too deep, however, sedation can cause significant adverse reactions, making it important to assess the degree of sedation and maintain its optimal level. We evaluated the efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechan...

We used functional MRI and the anesthetic agent propofol to assess the relationship among neural responses to speech, successful comprehension, and conscious awareness. Volunteers were scanned while listening to sentences containing ambiguous words, matched sentences without ambiguous words, and signal-correlated noise (SCN). During three scanning sessions, participants were nonsedated (awake),...

INTRODUCTION The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHOD...

Palliative sedation is undergoing extensive debate. The aims of this study were to describe the practice of palliative sedation at a specialized acute palliative care unit and to study whether patients who received palliative sedation differed from patients who did not. We performed a systematic retrospective analysis of the medical and nursing records of all 157 cancer patients who died at the...

BACKGROUND In February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are "obviously inappropriate" in a given medical situation,...