OBJECTIVE To implement sedation and delirium monitoring via a process-improvement project in accordance with Society of Critical Care Medicine guidelines and to evaluate the challenges of modifying intensive care unit (ICU) organizational practice styles. DESIGN Prospective observational cohort study. SETTING The medical ICUs at two institutions: the Vanderbilt University Medical Center (VU...

BACKGROUND AND OBJECTIVES Many Intensive Care Unit (ICU) patients present pain. The administration of analgesics and sedatives is crucial for patient comfort and to reduce stress, as well as to prevent delay in recovery and ventilator weaning. The objective of the present study was to conduct a review on analgesia and sedation in the ICU. CONTENT The present study reviewed the causes of pain,...

B ACKGROUND: Propofol is an intravenous anesthetic used worldwide as an anesthesia induction and maintenance agent. Propofol also used as sedation agent in Intensive Care Unit (ICU). Despite it’s usual anesthesia properties, propofol has an unique pharmacologic characteristic, especially as antioxidant and stress response reduction. These advantages suggested propofol has positive effects when ...

Objectives The aims of our study were: 1) to identify risk factors of sleep abnormalities in non-sedated ICU patients 2) to describe the consequences of sleep disturbances on the outcome. Patients and Methods This is an ancillary study of a single center randomized controlled trial. Inclusion criteria were: 1) no sedation for >24h, 2) sedation level < 3 on the Ramsay scale, 3) expected remainin...

BACKGROUND The aim of this study was to assess the impact on mechanical ventilation and ICU outcomes of substituting remifentanil for sufentanil, in an analgesia-based sedation protocol. A database of data prospectively collected was retrospectively analyzed. The study was carried out in a 16-bed tertiary-care ICU. METHODS The study included 1544 mechanically ventilated patients admitted from...

INTRODUCTION Patients in intensive care units (ICUs) are generally sedated for prolonged periods. Over-sedation and under-sedation both have negative effects on patient safety and resource use. We conducted a systematic review of the literature in order to establish the incidence of sub-optimal sedation (both over- and under-sedation) in ICUs. METHODS We searched Medline, Embase and CINAHL (C...

Background: Mechanical ventilation and sedation are inextricably linked components of critical care that represent, what we do for the patients during their vulnerable course in ICU. Aims: The aim of the present study is to evaluate the use of BIS for monitoring sedation in mechanically ventilated ICU patients and correlation of BIS with Sedation Agitation Scale. Settings and Design: Prospectiv...

INTRODUCTION Dexmedetomidine was shown in two European randomized double-blind double-dummy trials (PRODEX and MIDEX) to be non-inferior to propofol and midazolam in maintaining target sedation levels in mechanically ventilated intensive care unit (ICU) patients. Additionally, dexmedetomidine shortened the time to extubation versus both standard sedatives, suggesting that it may reduce ICU reso...