Background: Emergency care systems are at the core of modern healthcare and are the “point-of-entry/admission” into the hospital for many older/elderly patients. Among these, it is estimated that 15% to 30% will have delirium on admission and that over 50% will develop it during their stay. However, appropriate delirium diagnostic and screening still remains a critical area of need. The goal of...

• BACKGROUND Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort. • OBJECTIVE To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from me...

BACKGROUND We conducted a randomized trial to evaluate the opioid-sparing effect of an intraoperative infusion of dexmedetomidine (DEX) after craniotomy. METHODS Sixty adult patients scheduled for craniotomy were divided randomly into group A (DEX infusion at 0.5 μg/kg/h for 10 min and then adjusted to 0.2 to 0.5 μg/kg/h from tracheal intubation to incision suturing) and group B (0.9% saline ...

OBJECTIVE To develop and test the reliability and validity of the State Behavioral Scale for use in describing sedation/agitation levels in young intubated patients supported on mechanical ventilation. DESIGN : In this prospective, psychometric evaluation, pairs of trained pediatric critical care nurse evaluators simultaneously and independently assessed a convenience sample of pediatric inte...

Optimal sedation and analgesia are of key importance in intensive care. The aim of this study was to assess the quality of sedoanalgesia and outcome parameters in regimens containing midazolam and either fentanyl or remifentanil. A prospective, randomized, open-label, controlled trial was carried out in the ICU unit of a large teaching hospital in Istanbul over a 9-month period. Thirty-four pat...

CITATION Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J; Dexmedeto midine for Long-Term Sedation Investigators: Dexmedetomidine vesus midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 2012, 307:1151-1160. BACKGROUND Long-term sedation with midazolam or propofol in intensive care units (I...

UNLABELLED Emergence agitation is a frequent complication that can have serious consequences during recovery from general anesthesia. However, agitation has been poorly investigated in patients after craniotomy. In this prospective cohort study, adult patients were enrolled after elective craniotomy for brain tumor. The sedation-agitation scale was evaluated during the first 12 hours after surg...