INTRODUCTION Patients in intensive care units (ICUs) often receive sedation for prolonged periods. In order to better understand the impact of sub-optimal sedation practice on outcomes, we performed a systematic review, including observational studies and controlled trials which were conducted in sedated patients in the ICU and which compared the impact of changes in or different protocols for ...

STUDY OBJECTIVE To compare empiric and protocol-based therapies of sedation and analgesia in terms of pharmacologic cost, effects on mechanical ventilation and intensive care unit (ICU) stay, and quality of sedation and analgesia. DESIGN Prospective study. SETTING A 24-bed medical-surgical-neurologic ICU. PATIENTS Seventy-two patients evaluated during empiric therapy and 86 during protoco...

BACKGROUND Sedatives are administered to 85% of intensive care unit (ICU) patients. The most commonly used sedatives are intravenous benzodiazepines and propofol. These agents are associated with over-sedation in 40 to 60% of patients, which can lead to prolonged intubation, delirium and drug-induced hypotension. Evidence is increasing that volatile anesthetic agents are associated with faster ...

BACKGROUND: For logistical reasons sedation studies are often carried out in elective surgical patients and the results extrapolated to the general intensive care unit (ICU) population. We question the validity of this approach. We compared the two sedation regimens used in our general ICU in a trial structured to mimic clinical practice as closely as possible. RESULTS: Forty patients were rand...

BACKGROUND Managing anxiety, pain and delirium in critically ill patients is an ongoing challenge. Differences in physician practice, variations of pharmacological agents, as well as concentrations and units can increase the risk of medication error Personal preferences, subjectivity, and nurses' level of expertise are variables when titrating analgesic and sedation infusions. PURPOSE The pur...

BACKGROUND Sedation after open heart surgery is important in preventing stress on the heart. The unique sedative features of propofol prompted us to evaluate its potential clinical role in the sedation of post-CABG patients. OBJECTIVES To compare propofol-based sedation to midazolam-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). PATIENTS A...

OBJECTIVE Targeted temperature management after cardiac arrest requires deep sedation to prevent shivering and discomfort. Compared to IV sedation, volatile sedation has a shorter half-life and thus may allow more rapid extubation and neurologic assessment. DESIGN Observational analysis of clinical data. SETTING University hospital, medical ICU. PATIENTS Four hundred thirty-two cardiac ar...

Sedation strategies in intensive care units (ICU) have changed over the past decade towards daily wake-up calls, less sedation and even no sedation.(1-3) Furthermore, new ventilatory modes were designed to promote better patient synchrony with the ventilator and fewer sedation requirements. It is well known that the strategies used to reduce sedation reduce the length of mechanical ventilation ...

Sedation strategies in intensive care units (ICU) have changed over the past decade towards daily wake-up calls, less sedation and even no sedation.(1-3) Furthermore, new ventilatory modes were designed to promote better patient synchrony with the ventilator and fewer sedation requirements. It is well known that the strategies used to reduce sedation reduce the length of mechanical ventilation ...

Introduction Optimising sedation quality in mechanically ventilated intensive care patients is important because excessive sedation is associated with increased hospital acquired infections, longer intensive care (ICU) and hospital stay, and possibly higher mortality. The Development and Evaluation of Strategies to Improve Sedation Quality in InTensive Care (DESIST) study aims to optimise sedat...