Latest & greatest articles for sedation

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Top results for sedation

101. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. (PubMed)

Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. Protocolized sedation improves clinical outcomes in critically ill adults, but its effect in children is unknown.To determine whether critically ill children managed with a nurse-implemented, goal-directed sedation protocol experience fewer days of mechanical ventilation than patients receiving usual care.Cluster randomized trial conducted in 31 US (...) pediatric intensive care units (PICUs). A total of 2449 children (mean age, 4.7 years; range, 2 weeks to 17 years) mechanically ventilated for acute respiratory failure were enrolled in 2009-2013 and followed up until 72 hours after opioids were discontinued, 28 days, or hospital discharge.Intervention PICUs (17 sites; n = 1225 patients) used a protocol that included targeted sedation, arousal assessments, extubation readiness testing, sedation adjustment every 8 hours, and sedation weaning. Control

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2015 JAMA

102. Protocol-directed sedation versus non-protocol-directed sedation to reduce duration of mechanical ventilation in mechanically ventilated intensive care patients. (PubMed)

Protocol-directed sedation versus non-protocol-directed sedation to reduce duration of mechanical ventilation in mechanically ventilated intensive care patients. The sedation needs of critically ill patients have been recognized as a core component of critical care and meeting these is vital to assist recovery and ensure humane treatment. There is growing evidence to suggest that sedation requirements are not always optimally managed. Sub-optimal sedation incorporates both under- and over (...) -sedation and has been linked to both short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Various strategies have been proposed to improve sedation management and address aspects of assessment as well as delivery of sedation.To assess the effects of protocol-directed sedation management on the duration of mechanical ventilation and other relevant patient outcomes in mechanically ventilated intensive care unit (ICU) patients. We looked at various outcomes and examined

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2015 Cochrane

103. Palliative pharmacological sedation for terminally ill adults. (PubMed)

Palliative pharmacological sedation for terminally ill adults. Terminally ill people experience a variety of symptoms in the last hours and days of life, including delirium, agitation, anxiety, terminal restlessness, dyspnoea, pain, vomiting, and psychological and physical distress. In the terminal phase of life, these symptoms may become refractory, and unable to be controlled by supportive and palliative therapies specifically targeted to these symptoms. Palliative sedation therapy is one (...) potential solution to providing relief from these refractory symptoms. Sedation in terminally ill people is intended to provide relief from refractory symptoms that are not controlled by other methods. Sedative drugs such as benzodiazepines are titrated to achieve the desired level of sedation; the level of sedation can be easily maintained and the effect is reversible.To assess the evidence for the benefit of palliative pharmacological sedation on quality of life, survival, and specific refractory

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2015 Cochrane

104. Dexmedetomidine for Sedation in the ICU or PICU

Dexmedetomidine for Sedation in the ICU or PICU TITLE: Dexmedetomidine for Sedation in the ICU or PICU: A Review of Cost- Effectiveness and Guidelines DATE: 17 December 2014 CONTEXT AND POLICY ISSUES Sedation of ICU patients is often essential for ICU patients to maximize survival, reduce ICU and hospital stay, and facilitate mechanical ventilation. 1 The standard of care for sedation includes benzodiazepine sedatives and propofol. 1 These sedatives (notably benzodiazepines) are associated (...) with an increased risk of agitation and delirium. 1 It has been hypothesized that dexmedetomidine would be an appropriate alternative to traditional sedatives for maintaining light to moderate sedation. Dexmedetomidine is an alpha 2 -adrenergic agonist, and it is approved in Canada for intensive care unit sedation and conscious sedation. 2 In January 2014, the Canadian Agency for Drugs and Technologies in Health (CADTH) reviewed the evidence on the clinical effectiveness of using dexmedetomidine for sedation

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

105. Prospective multicentre randomised, double-blind, equivalence study comparing clonidine and midazolam as intravenous sedative agents in critically ill children: the SLEEPS (Safety profiLe, Efficacy and Equivalence in Paediatric intensive care Sedation) st

Prospective multicentre randomised, double-blind, equivalence study comparing clonidine and midazolam as intravenous sedative agents in critically ill children: the SLEEPS (Safety profiLe, Efficacy and Equivalence in Paediatric intensive care Sedation) st Prospective multi-centre randomised, double-blind, equivalence study comparing clonidine and midazolam as intravenous sedative agents in critically ill children. The SLEEPS Study (Safety ProfiLe, Efficacy and Equivalence in Paediatric (...) intensive care Sedation) Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} {{author}} {{($index , , , , , , & . Andrew Wolf 1, * , Andrew McKay 2 , Catherine Spowart 2

2015 NIHR HTA programme

106. ESMO Clinical Practice Guidelines for the Management of Refractory Symptoms at the End of Life and the Use of Palliative Sedation

ESMO Clinical Practice Guidelines for the Management of Refractory Symptoms at the End of Life and the Use of Palliative Sedation ESMOClinicalPracticeGuidelinesforthemanagement ofrefractorysymptomsattheendoflifeandtheuseof palliativesedation † N.I.Cherny 1 ,onbehalfoftheESMOGuidelinesWorkingGroup * 1 DepartmentofMedicalOncology,ShaareZedekMedicalCenter,Jerusalem,Israel Levelofevidencestatement: Since there are no randomised studies addressing this issue, all assertions are level V based on case (...) with routine measures, and that sedation may be needed to attain adequaterelief[26]. epidemiologyofrefractorysymptomsattheend oflife Among patients with advanced cancer, clinical experience sug- gests that optimal palliative care can effectively manage the symptoms of most cancer patients during most of the course of the disease. Although physical and psychological symptoms † ApprovedbytheESMOGuidelinesWorkingGroup:July2014. *Correspondence to: ESMO Guidelines Working Group, ESMO Head Of?ce, Via L. Taddei

2014 European Society for Medical Oncology

107. Dexmedetomidine for sedation of patients in the ICU or PICU: review of clinical effectiveness and safety

Dexmedetomidine for sedation of patients in the ICU or PICU: review of clinical effectiveness and safety Dexmedetomidine for sedation of patients in the ICU or PICU: review of clinical effectiveness and safety Dexmedetomidine for sedation of patients in the ICU or PICU: review of clinical effectiveness and safety CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made (...) for the HTA database. Citation CADTH. Dexmedetomidine for sedation of patients in the ICU or PICU: review of clinical effectiveness and safety. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary with Critical Appraisal. 2014 Authors' conclusions Four meta-analyses, one systematic review, and five randomized-controlled trials were included in this review. The available evidence indicates the use of dexmedetomidine was associated with decreased ICU stay

2014 Health Technology Assessment (HTA) Database.

108. Daily sedation interruption versus no daily sedation interruption for critically ill adult patients requiring invasive mechanical ventilation. (PubMed)

Daily sedation interruption versus no daily sedation interruption for critically ill adult patients requiring invasive mechanical ventilation. Daily sedation interruption (DSI) is thought to limit drug bioaccumulation, promote a more awake state, and thereby reduce the duration of mechanical ventilation. Available evidence has shown DSI to either reduce, not alter, or prolong the duration of mechanical ventilation.The primary objective of this review was to compare the total duration (...) of invasive mechanical ventilation for critically ill adult patients requiring intravenous sedation who were managed with DSI versus those with no DSI. Our other objectives were to determine whether DSI influenced mortality, intensive care unit (ICU) and hospital lengths of stay, adverse events, the total doses of sedative drug administered, and quality of life.We searched, from database inception to February 2014, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014

2014 Cochrane

109. A Patient-Blinded Randomized, Controlled Trial Comparing Air Insufflation, Water Immersion, and Water Exchange During Minimally Sedated Colonoscopy (PubMed)

A Patient-Blinded Randomized, Controlled Trial Comparing Air Insufflation, Water Immersion, and Water Exchange During Minimally Sedated Colonoscopy Minimal sedation obviates patient recovery burdens, but intolerable pain limits success of cecal intubation. Painless or minimally uncomfortable insertion ensures success of cecal intubation, current patient satisfaction, and willingness to repeat future colonoscopy with minimal sedation. Water immersion (WI) and water exchange (WE), when separately (...) compared with air insufflation (AI), significantly reduced insertion pain. To assess comparative effectiveness, we conducted a randomized controlled trial with head-to-head comparison of these three methods. We hypothesized that WE could produce the highest proportion of patients reporting painless insertion.This prospective patient-blinded trial (NCT01535326) enrolled minimally sedated (25 mg intramuscular meperidine) patients randomized to AI, WI, or WE (90 patients/group) to aid insertion

2014 EvidenceUpdates

110. Opioid-induced sedation scales

Opioid-induced sedation scales Opioid-induced sedation scales Opioid-induced sedation scales Leas B, Betesh J Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Leas B, Betesh J. Opioid-induced sedation scales. Philadelphia: Center for Evidence-based Practice (CEP). 2014 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Analgesics, Opioids

2014 Health Technology Assessment (HTA) Database.

111. Are patients who have used chewing gum at an increased risk of aspiration during sedation?

Are patients who have used chewing gum at an increased risk of aspiration during sedation? BestBets: Are patients who have used chewing gum at an increased risk of aspiration during sedation? Are patients who have used chewing gum at an increased risk of aspiration during sedation? Report By: Dr Tom Jaconelli - ST3 Emergency Medicine Search checked by Dr Will Townend - Consultant in Emergency Medicine Institution: Hull Royal Infirmary Date Submitted: 28th November 2013 Date Completed: 30th (...) April 2014 Last Modified: 30th April 2014 Status: Green (complete) Three Part Question Can[patients considered for procedural sedation in the emergency department]who have [chewed chewing gum in the preceding six hours] be [deemed fasted]? Clinical Scenario A 37 year old male presents with an anterior shoulder dislocation following a rugby match. He states he has not ingested solids for 6 hours or fluids for 2 hours. As you are consenting him for procedural sedation you notice he is chewing gum

2014 BestBETS

112. Propofol sedation for flexible bronchoscopy: a randomised, noninferiority trial (PubMed)

Propofol sedation for flexible bronchoscopy: a randomised, noninferiority trial Propofol has been established as a reliable method for sedation in flexible bronchoscopy. There are no data comparing propofol administered as intravenous boluses versus continuous infusion. 702 consecutive patients undergoing flexible bronchoscopy were randomly allocated to receive intravenous propofol using either an intermittent bolus technique or a continuous infusion. The primary end-point was the number

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2014 EvidenceUpdates

113. The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures

The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures Burnett H, Lambley R, West S, Ungar WJ, Mireskandari K Record Status This is a bibliographic (...) record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Burnett H, Lambley R, West S, Ungar WJ, Mireskandari K. The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. Toronto: Technology Assessment at SickKids (TASK). 2014 Authors' objectives The primary objective was to determine the incremental cost of paediatric eye examinations

2014 Health Technology Assessment (HTA) Database.

114. Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures Background Paper

Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures Background Paper PS09 BP 2014 Page 1 PS09 BP 2014 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures Background Paper PURPOSE OF REVIEW Sedation and/or analgesia are commonly employed for medical, dental and surgical procedures by a range of health practitioners (...) with diverse qualifications and training, including anaesthetists, other medical practitioners and dentists. The goal of ANZCA professional document PS09 Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures is to support uniform standards for high quality and safe administration of procedural sedation and/or analgesia by all appropriately qualified health practitioners in Australia and New Zealand. The document was last reviewed in 2010

2014 Australian and New Zealand College of Anaesthetists

115. Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures

Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures PS09 2014 Page 1 PS09 2014 Australian and New Zealand College of Anaesthetists (ANZCA) Faculty of Pain Medicine The following organisations have endorsed this document: Australasian College for Emergency Medicine College of Intensive Care Medicine of Australia and New Zealand Gastroenterological Society of Australia New Zealand Society for Gastroenterology Royal Australasian College (...) of Surgeons Royal Australian and New Zealand College of Psychiatrists Royal Australian and New Zealand College of Radiologists Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures This document is intended to apply wherever procedural sedation and/or analgesia for diagnostic and interventional medical, dental and surgical procedures are administered, but excludes situations where sedation is used for longer term management of patients

2014 Australian and New Zealand College of Anaesthetists

116. Procedural Sedation and Analgesia in the Emergency Department

Procedural Sedation and Analgesia in the Emergency Department ACEP // Procedural Sedation and Analgesia Popular Recommendations PEER ultrasound LLSA sepsis Log In Log In Topics Practice Education Advocacy About ACEP Topics TOPICS Quick Access Current News Practice Administration Life as a Physician Patient Care By Medical Focus Education In Education Bedside Tools Upcoming Conferences Earn CME Now Featured Publication Advocacy Federal Advocacy State Advocacy Get Involved Groups to Join About (...) ACEP Who We Are How We Serve What We Believe Membership FEATURED BENEFIT Popular Recommendations PEER ultrasound LLSA sepsis QUICK ACCESS CURRENT NEWS TOPICS BY MEDICAL FOCUS ADMINISTRATION LIFE AS A PHYSICIAN PATIENT CARE UPCOMING CONFERENCES EARN CME NOW FEATURED PUBLICATION IN EDUCATION BEDSIDE TOOLS GROUPS TO JOIN FEDERAL ADVOCACY STATE ADVOCACY GET INVOLVED MEMBERSHIP FEATURED BENEFIT WHO WE ARE HOW WE SERVE WHAT WE BELIEVE / / Procedural Sedation and Analgesia Procedural Sedation

2014 American College of Emergency Physicians

117. Dexmedetomidine for sedation in the ICU or PICU: a review of cost-effectiveness and guidelines

Dexmedetomidine for sedation in the ICU or PICU: a review of cost-effectiveness and guidelines Dexmedetomidine for sedation in the ICU or PICU: a review of cost-effectiveness and guidelines Dexmedetomidine for sedation in the ICU or PICU: a review of cost-effectiveness and guidelines CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation (...) CADTH. Dexmedetomidine for sedation in the ICU or PICU: a review of cost-effectiveness and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response. 2014 Authors' conclusions Six economic evaluations and two guidelines were included in this review. All except one economic study showed that dexmedetomidine was associated with lower ICU and hospital costs. However, the clinical benefits were marginal and not consistent in the included studies. The included

2014 Health Technology Assessment (HTA) Database.

118. Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures

Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures PS09 2014 Page 1 PS09 2014 Australian and New Zealand College of Anaesthetists (ANZCA) Faculty of Pain Medicine The following organisations have endorsed this document: Gastroenterological Society of Australia Royal Australasian College of Surgeons Australasian College for Emergency Medicine College of Intensive Care Medicine of Australia and New Zealand Royal Australian and New (...) Zealand College of Radiologists Royal Australian and New Zealand College of Psychiatrists Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures This document is intended to apply wherever procedural sedation and/or analgesia for diagnostic and interventional medical, dental and surgical procedures are administered, but excludes situations where sedation is used for longer term management of patients such as in intensive care units

2014 Australian and New Zealand College of Anaesthetists

119. Randomized, Double-Blinded, Clinical Trial of Propofol, 1:1 Propofol/Ketamine, and 4:1 Propofol/Ketamine for Deep Procedural Sedation in the Emergency Department (PubMed)

Randomized, Double-Blinded, Clinical Trial of Propofol, 1:1 Propofol/Ketamine, and 4:1 Propofol/Ketamine for Deep Procedural Sedation in the Emergency Department We compare the frequency of airway and respiratory adverse events leading to an intervention between propofol with 1:1 and 4:1 mixtures of propofol and ketamine (ketofol).We performed a randomized, double-blinded trial in which emergency department adults undergoing deep sedation received propofol, 1:1 propofol and ketamine, or 4:1 (...) propofol and ketamine. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention. Other outcomes included sedation depth, efficacy, procedure and recovery time, patient satisfaction, pain, and procedural recall.Two hundred seventy-one subjects completed the trial, 90 receiving propofol, 85 receiving 1:1 propofol and ketamine, and 96 receiving 4:1 propofol and ketamine. Airway or respiratory adverse events leading to an intervention were similar between

2014 EvidenceUpdates

120. Observational study: In China the use of analgesics and sedation following paediatric cardiac surgery is variable; average pain scores are reported to be good but over-sedation is common

Observational study: In China the use of analgesics and sedation following paediatric cardiac surgery is variable; average pain scores are reported to be good but over-sedation is common In China the use of analgesics and sedation following paediatric cardiac surgery is variable; average pain scores are reported to be good but over-sedation is common | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie (...) and sedation following paediatric cardiac surgery is variable; average pain scores are reported to be good but over-sedation is common Article Text Child health Observational study In China the use of analgesics and sedation following paediatric cardiac surgery is variable; average pain scores are reported to be good but over-sedation is common Anne-Sylvie Ramelet 1 , 2 Statistics from Altmetric.com Commentary on: Bai J , Hsu L . Pain status and sedation level in Chinese children after cardiac surgery

2014 Evidence-Based Nursing