Articles: hypnotics-sedatives.
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Intensive care medicine · Feb 2009
Randomized Controlled Trial Multicenter StudyDexmedetomidine versus propofol/midazolam for long-term sedation during mechanical ventilation.
To compare dexmedetomidine (DEX) with standard care (SC, either propofol or midazolam) for long-term sedation in terms of maintaining target sedation and length of intensive care unit (ICU) stay. ⋯ This pilot study suggests that in long-term sedation, DEX is comparable to SC in maintaining sedation targets of RASS 0 to -3 but not suitable for deep sedation (RASS -4 or less). DEX had no effect on length of ICU stay. Its effects on other relevant clinical outcomes, such as duration of mechanical ventilation, should be tested further.
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Randomized Controlled Trial Multicenter Study
A phase 3, randomized, double-blind study to assess the efficacy and safety of fospropofol disodium injection for moderate sedation in patients undergoing flexible bronchoscopy.
Fospropofol disodium is a water-soluble prodrug of propofol with unique pharmacokinetic/pharmacodynamic properties. This randomized, double-blind, multicenter study evaluated the use of fospropofol in patients undergoing flexible bronchoscopy. ⋯ Fospropofol provided safe and effective sedation for patients undergoing flexible bronchoscopy.
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Multicenter Study
Standards of practice in UK emergency departments before, during and after conscious sedation.
The agents used for conscious sedation are well known to have potentially serious complications. It is recommended that patients receiving them should be objectively monitored until it is deemed safe. An audit of our departmental practices led us to conduct a national questionnaire to determine how we compared with other units in the UK. ⋯ Certain practices were applied in most departments but none were universal, with most being subject to wide variation. The local results reflected this, suggesting that a variation may exist both within and between individual units.
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Multicenter Study
Drug withdrawal, cocaine and sedative use disorders increase the need for mechanical ventilation in medical patients.
Alcohol use disorders increase the need for mechanical ventilation (MV) in critically ill medical, surgical and trauma patients. Studies examining other drug use disorders (DUD) in trauma patients have not demonstrated heightened rates of intensive care unit (ICU) complications. Patients with asthma and concurrent cocaine or heroin use disorders have an increased need for MV. The objective of this study is to determine if the presence of DUD and drug withdrawal syndromes are associated with increased need for MV in medical patients. ⋯ DUD are associated with increased need for MV in medical patients. This study demonstrates the importance of screening all medical patients for DUD.
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Critical care medicine · Aug 2008
Multicenter StudyWithdrawal symptoms in critically ill children after long-term administration of sedatives and/or analgesics: a first evaluation.
To establish frequencies of benzodiazepine and opioid withdrawal symptoms, and correlations with total doses and duration of administration. ⋯ This is the first study to report frequencies of all 24 withdrawal symptoms observed in children after decrease or discontinuation of benzodiazepines and/or opioids. Agitation, anxiety, muscle tension, sleeping <1 hr, diarrhea, fever, sweating, and tachypnea were observed most frequently. Longer duration of use and high dosing are risk factors for development of withdrawal symptoms in children.