Editor’s key points † Dexmedetomidine may offer advantages over midazolam when used for sedation in Intensive Care Unit (ICU) patients. † The authors undertook a critical appraisal of randomized controlled trials which have addressed this issue. † So far the evidence of advantages of dexmedetomidine in ICU setting remains limited. † The authors recommend more research using robust methodology a...

PURPOSE OF REVIEW Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidel...

BACKGROUND Dexmedetomidine is an α(2)-receptor agonist administered by continuous infusion in the intensive care unit (ICU) for sedation of critically ill patients who are undergoing mechanical ventilation following intubation. Relative to ICU patients receiving midazolam (a γ-aminobutyric acid agonist) for sedation, those receiving dexmedetomidine spent less time on ventilation, had fewer epis...

INTRODUCTION The critically-ill undergoing inter-hospital transfers commonly receive sedatives in continuation of their therapeutic regime or to facilitate a safe transfer shielded from external stressors. While sedation assessment is well established in critical care in general, there is only little data available relating to the special conditions during patient transport and their effect on ...

BACKGROUND For patients in the intensive care unit (ICU) or under monitored anesthetic care (MAC), the precise monitoring of sedation depth facilitates the optimization of dosage and prevents adverse complications from underor over-sedation. For this purpose, conventional subjective sedation scales, such as the Observer's Assessment of Alertness/Sedation (OAA/S) or the Ramsay scale, have been w...

INTRODUCTION The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. METHOD This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hou...

INTRODUCTION Protocols for the delivery of analgesia, sedation and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniformly used. The extent to which elements of analgesia, sedation and delirium guidelines are incorporated into order sets at hospitals across a geographic area is not known. We hypothesized that both greater ho...

Objective To show the effect of dual monitoring including cardiac output (CO) and intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI) patiens. We hypothesized that meticulous treatment using dual monitoring is effective to sustain maintain minimal intensive care unit (ICU) complications and maintain optimal ICP and cerebral perfusion pressure (CPP) for severe TBI pati...

Recognition and treatment of pain, agitation and anxiety is a challenge in the care of Intensive Care Unit (ICU) patients. Management of pain, agitation and anxiety is necessary for patient comfort, and reduces long term psychological sequelae of ICU admission, time on mechanical ventilation, and length of stay in both the ICU and hospital. ICU providers must be very familiar with the pharmacol...

In our daily practice in intensive care unit, one of the “cornerstones” is to achieve adequate sedation for every patient. Intensive care unit (ICU) patients are often sedated, and a good hypnotic monitoring is important to assure an optimal level of sedation for every patient. Sedation monitoring can be achieved using subjective or objective methods. The most recent recommendations on manageme...