Search Tag: sedation
2025 07 Jan
The evolution of critical care medicine has greatly advanced understanding and practices in pain and sedation management. Historically, deep sedation was believed to aid recovery, but it is now recognised to delay recovery and increase harm. Current strategies emphasise carefully titrated analgesia and sedation to ensure patient comfort, safety, and...Read more
2024 09 Apr
Delirium is a common psychiatric syndrome in critically ill patients, associated with high mortality rates and long-term cognitive decline. Recent trials on medication-based treatments have not shown significant benefits, leading to a shift towards nonpharmacologic approaches. The Society of Critical Care Medicine recommends comprehensive...Read more
2023 23 Dec
Change has been the only constant since the start of the Industrial Revolution. Thinking about how the world has evolved and transformed over time is fascinating. Key areas where technology can further this transformation are robotics and sedation. At first, robotics and sedation have nothing in common. However, technological advances, such...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 20 Oct
Lung-protective ventilation (LPV) limits lung injury (VILI). However, deep sedation is required to tolerate LPV, and patient self-induced lung injury (P-SILI) can occur during spontaneous breathing along with high respiratory efforts, lung stress and strain. Prevention of P-SILI may require further sedation. In addition, patient-ventilator dyssynchrony...Read more
2022 20 Jun
Sedation management is a critical component when managing mechanically ventilated patients. It is important to use a protocol-driven approach, which favours paired spontaneous awakening (SAT) and breathing (SBT) trials, along with light levels of sedation. The initial period of respiratory failure in the emergency department and the first 48 hours...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 25 May
An overview of the cardiovascular and respiratory effects of sedative agents commonly used in the ICU, emerging concepts of mechanical ventilation induced injury to the respiratory muscles and evolving concepts for sedation monitoring and sedation minimisation to achieve the goal of expeditious liberation from mechanical ventilation. The...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 09 Mar
The misuse of opioids is a major public health issue in many countries. Excessive use of opioids in the U.S. in particular, is primarily driven by pharmaceutical companies promoting the liberal use of opioids. Also, the American Pain Society describes pain as the fifth vital sign, which has resulted in a generous prescribing and widespread misuse of...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
The COVID-19 pandemic has had a significant impact on ICUs and critical care healthcare providers all across the globe. As of this week, 110 million people have been infected with the virus worldwide, and 2.4 million have died. Many of the infected patients need hospitalisation and admission to the ICU. A high percentage of severely ill patients with...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
2021 01 Feb
A study was conducted to evaluate opioid use in the ICU and identify factors associated with chronic opioid use after critical care. It also aimed to determine if chronic opioid use was associated with an increased risk of death. Over the last few years, opioid misuse has become a major public health issue in many countries. Pharmaceutical companies...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
2020 15 Jan
Subject Index for Volume 19, issues 1-4, 2019. Issue Pages Link Issue 1 1-64 https://iii.hm/10cv Issue 2 65-128 https://iii.hm/10cw Issue 3 129-192 https://iii.hm/10cx Issue 4 193-256 https://iii.hm/10cy Acute Respiratory Distress Syndrome Use of sedation...Read more
2019 01 Oct
Palle Toft of Odense University Hospital presented the findings of the “No sedation compared to sedation with a daily wake-up trial. A prospective randomized multicentre study - The NONSEDA-study” @ESICM in Berlin. The NON-SEDA study is a Scandinavian multicentre study conducted in Denmark, Norway, and Sweden that compared non-sedation with light...Read more
2019 30 May
This article describes the rise in PICU-acquired morbidities and its impact on patient outcomes. It discusses early rehabilitation strategies to improve patient outcomes in PICU. Introduction Critical care has traditionally been focused on early recognition of life-threatening conditions, resuscitation, and stabilisation of organ...Read more
2019 30 May
According to a National Institutes of Health sponsored clinical trial that was conducted at several North American hospitals and was led by clinician-scientists at the University of Pittsburgh and University of Colorado schools of medicine, reversibly paralysing and sedating hospitalised patients with severe breathing problems does not prove improve...Read more
2019 23 Apr
A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes. The study's main objective was to determine the relationship between sedation status and 90-day mortality. Study results...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