conclusions propofol provided a safe and acceptable sedation for post-cabg surgical patients, significantly reduced the requirement for analgesics, and allowed for more rapid tracheal extubation than midazolam but did not result in earlier icu discharge. results the depth of sedation was almost the same in the two groups (rss=4.5 in midazolam group vs 4.7 in propofol group; p = 0.259) but the t...

Heavy sedation in the ICU is associated with coma, delirium, and prolonged stays, but links between sedatives and non-brain organ failure have rarely been described. In a post hoc analysis, Strøm and colleagues explored associations between sedation and acute kidney injury among ICU patients randomly assigned to one of two sedation strategies. The 'no sedation' protocol was associated with less...

Dexmedetomidine (DEX), a highly selective α(2)-adrenergic receptor agonist, is the newest agent introduced for sedation in intensive care unit (ICU). The sedation strategy for critically ill patients has stressed light sedation with daily awakening and assessment for neurologic, cognitive, and respiratory functions, since Society of Critical Care Medicine (SCCM) guidelines were presented in 200...

OBJECTIVE Deep sedation and delirium are common in the ICU. Mechanically ventilated patients with acute lung injury are at especially high risk for deep sedation, delirium, and associated long-term physical and neuropsychiatric impairments. We undertook an ICU-wide structured quality improvement project to decrease sedation and delirium. DESIGN Prospective quality improvement project in compa...

Many studies have documented patients' distressing recollections of the intensive care unit (ICU). The study by van de Leur and colleagues, conducted in a group of surgical ICU patients with moderate severity of sickness, found that the frequency of such unpleasant memories was increased in those able to recall factual information about their stay in the ICU. The study did not include sedation ...

INTRODUCTION Sedation protocols have demonstrated effectiveness in improving ICU sedation practices. However, the importance of multifaceted multidisciplinary approach on the success of such protocols has not been fully examined. METHODS The study was conducted in a tertiary care medical-surgical ICU as a prospective, 4-pronged, observational study describing a quality improvement initiative ...

Critical illness impairs physical function. The NONSEDA trial was a multicenter randomized trial, assessing non-sedation versus sedation during mechanical ventilation. aim of this sub-study to assess the effect on All patients from one site were included. At ICU discharge and three months thereafter, survivors assessed for 205 included, 118 survived follow-up, 116 participated (98%). Primary ou...

All critically ill children have the right to adequate relief of their pain Correctable physical and environmental factors causing discomfort should be addressed using non-pharmacologic interventions before the initiation of pharmacologic interventions. The choice of sedative-analgesic agent and its initial dose are selected on the basis of several factors such as cause of the distress, desire ...

INTRODUCTION There is increasing evidence that deep sedation is detrimental to critically ill patients. The aim of this study was to examine effects of deep sedation during the early period after ICU admission on short- and long-term survival. METHODS In this observational, matched-pair analysis, patients receiving mechanical ventilation that were admitted to ICUs of a tertiary university hos...