BACKGROUND AND OBJECTIVES Sedative and analgesic treatment administered to critically ill patients need to be regularly assessed to ensure that previously stated goals are well achieved as the risk of complications of oversedation is minimized. We revised and prospectively tested the Ramsay Sedation Scale (RSS) for interrater reliability and compared it with the Riker Sedation-Agitation Scale (...

BACKGROUND A relevant innovation about sedation of long-term Intensive Care Unit (ICU) patients is the 'conscious target': patients should be awake even during the critical phases of illness. Enteral sedative administration is nowadays unusual, even though the gastrointestinal tract works soon after ICU admission. The enteral approach cannot produce deep sedation; however, it is as adequate as ...

Providing effective analgesia and adequate sedation is a generally accepted goal of intensive care medicine. Due to its rapid, organ independent and predictable metabolism the short acting opioid remifentanil might be particularly useful for analgesia-based sedation in the intensive care unit (ICU). This hypothesis was tested by two studies in this issue of Critical Care. The study by Breen et ...

BACKGROUND The goal of the current study was to evaluate the economic impact of propofol as compared with midazolam for sedating patients in the intensive care unit (ICU). METHODS A randomized, unblinded, multicenter pharmacoeconomic trial captured health resource utilization and outcome measurements associated with sedation and treatment of patients in four ICUs across Canada. Statistical an...

AIMS Dexmedetomidine (dexdor®) is approved in the European Union (EU) for sedation of adults in the intensive care unit (ICU). The present observational, retrospective study was requested by the European Medicines Agency to investigate dexmedetomidine use in clinical practice, with a particular focus on off-label use, including the paediatric population. METHODS Study countries and sites were...

BACKGROUND The effects of non-sedation on cognitive function in critically ill patients on mechanical ventilation are not yet certain. This trial is a substudy of the NONSEDA trial where critically ill patients are randomized to non-sedation or to sedation with a daily wake-up attempt during mechanical ventilation in the intensive care unit (ICU). The aim of this substudy is to assess the effec...

RATIONALE Choice and intensity of early (first 48 h) sedation may affect short- and long-term outcome. OBJECTIVES To investigate the relationships between early sedation and time to extubation, delirium, and hospital and 180-day mortality among ventilated critically ill patients in the intensive care unit (ICU). METHODS Multicenter (25 Australia and New Zealand hospitals) prospective longit...

INTRODUCTION Midazolam is used routinely to sedate patients in the intensive care unit (ICU). We suspected that midazolam over-sedation was occurring in the ICU of the Guy's and St. Thomas' Trust and that it could be difficult to differentiate this from underlying neurological damage. A sensitive assay for detecting midazolam and 1-hydroxymidazolam glucuronide (1-OHMG) in serum was developed an...

C ill patients requiring invasive vital support such as mechanical ventilation almost uniformly show anxiety, agitation and pain during their Intensive Care Unit (ICU) stay. The use of analgesic and sedative drugs is essential to improve comfort, reduce anxiety and facilitate nursing care, despite the fact that these drugs present several side effects. In the past decades, liberal doses of prop...

Background: Patients discharged from an intensive care unit (ICU) often experience painful ICU memories during recovery. Distorted memories are particularly associated with post ICU mental health disorders. Our study aims were to investigate patents’ distorted memory of ICU and related factors. Methods: Twenty-one patients enrolled in this study. The distorted memories were assessed by the ICU ...