Search Tag: Analgesia
2024 17 May
Pain is defined as an unpleasant sensory and emotional experience. Among patients admitted to the Intensive Care Unit (ICU), severe untreated pain is associated with an increase in mortality, length of hospital stays and worsening in everyday quality of life after hospital discharge. Pain in critically ill patients is more difficult to monitor...Read more
2023 30 Nov
In the ICU, providing better care with less is the holy grail. This mnemonic tries to resume a list of the key interventions for human, evidence-based and patient-centred care. Background In 2005, Prof Jean-Louis Vincent introduced the mnemonic "FAST HUG," advocating for a comprehensive approach to patient care encompassing seven...Read more
2022 25 May
A Practical Approach for Intensivists A practical approach to analgesia, sedation and neuromuscular blockade of critically ill patients and a discussion on potential benefits, adverse effects and current professional international recommendations. Introduction Patients hospitalised in the Intensive Care Unit (ICU) are naturally prone to...Read more
2022 08 Feb
Pain is one of the most distressful symptoms among critically ill patients, along with shortness of breath and delirium. Pain is reported by 38 to 51% of patients at risk of dying. Delirium is highly prevalent among patients who are critically ill and is associated with worse short-term and long-term outcomes, including in-hospital mortality, longer...Read more
2021 19 Apr
An overview of strategies and measures that can be implemented to improve wellbeing of staff and patients in the ICU. 1. Make the patient the centre of our preoccupations This is the first principle of wellbeing in the ICU and should be written in large letters when one enters an ICU. Wellbeing must concern first and foremost the patient....Read more
2021 19 Apr
During the first year, the ICU director should take a snapshot of the ICU situation and invest time and resources to acquire good and real data that will drive priorities of care and management. After that, implementation of basic protocols and creating a programme to engage and protect the staff against burnout should be considered. Finally, we...Read more
2021 22 Feb
C OVID-19 patients present to the hospital with lung involvement and interstitial pneumonia eventually associated with lung collapse. The clinical picture is dominated by severe hypoxaemia without dyspnoea/tachypneoa and normal respiratory mechanics; this condition has been defined as silent hypoxia. The picture may evolve, and these patients may...Read more
2021 22 Feb
Clinical Practice Guidelines The Choosing Wisely top five guidelines published a few years ago by the Chest Association of Physicians, the American Thoracic Society, the Society of Critical Care Medicine, and the American Association of Critical Care Nurses state that mechanically ventilated patients should not be deeply sedated without a specific...Read more
2021 22 Feb
During the question/answer session, Prof Vito Marco Ranieri discussed some important questions with Prof Salvatore Maurizio Maggiore and Prof Boris Jung regarding sedation regimen, respiratory muscle paralysis, sedation in COVID-19 patients specifically and how it is different from other regular ICU patients. Ranieri: What is your opinion...Read more
2021 22 Feb
Report of a Symposium Presented at LIVES 2020 33rd Congress of the European Society of Intensive Care Medicine Moderator Vito Marco Ranieri (Bologna, Italy) Speakers Why Do We Need Sedation in Critically-Ill COVID-19 Patients? Salvatore Maurizio Maggiore (Chieti, Italy) How Should We Manage Sedation in Critically-Ill...Read more
2020 15 Jan
Critical Care Medicine has existed for many years, but was only recognised as a specialty in the last 40 years or so. However, during this time, there has been a tremendous amount of change. Over the years, our understanding of different critical illnesses has improved, and our treatment strategies have become more effective. Technology has also played...Read more
2020 15 Jan
From massive sedation in the past, through current patient-centred sedation protocols, the future may further improve sedation in the ICU. Introduction The concepts for an optimal sedation in the intensive care unit (ICU) should include: Definition of the optimal depth of sedation; The need for agents with on/off effects; The...Read more
2019 14 Mar
Managing sedation analgesia for patient-centred care in the ICU Pain management and sedation are closely linked in the intensive care unit. In the past, clinicians were using sedative agents too liberally, often with benzodiazepines. And several issues were observed in the ICU, including the problems of delirium, weakness and prolonged ICU...Read more
2019 14 Mar
How to manage sedation analgesia for patient-centred care in the ICU. In the concept of patient-centered care, sedation and analgesia have high importance. Intensive care is sometimes invasive and very painful. Patients in the ICU are seriously ill and often suffer from anxiety, agitation, and pain. There is sometimes a need to use deep and...Read more
2016 30 May
Obese patients without other major co-morbidities are categorised as class II according to the American Society of Anesthesiologists (ASA) physical status classification ( https://iii.hm/38j ). If additional organ dysfunction is present they are categorised as ASA III. These patients are at increased risk for metabolic, cardiovascular and pulmonary complications....Read more
2015 23 Jun
Two randomised controlled trials of patient-administered patient relief in the emergency department have found that they are effective in reducing pain. Currently, patients arriving in emergency departments may be administered morphine intravenously by a nurse. Whilst this is safe and works, it takes up nursing time. Two randomised controlled trials...Read more