Articles: hypnotics-sedatives.
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Multicenter Study Observational Study
Prospective Observational Evaluation of Sedation and Pain Management Guideline Adherence Across New Jersey Intensive Care Units.
The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013. ⋯ Current sedation practices suggest that integration of evidence-based PAD guidelines across New Jersey adult ICUs is inconsistent despite pharmacist involvement.
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Multicenter Study
Propofol does not affect the reliability of early EEG for outcome prediction of comatose patients after cardiac arrest.
To quantify the effects of propofol on the EEG after cardiac arrest and to assess their influence on predictions of outcome. ⋯ We confirm the reliability of EEG-based outcome predictions in propofol-sedated patients after cardiac arrest.
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Multicenter Study Comparative Study
Comparison of phenobarbital-adjunct versus benzodiazepine-only approach for alcohol withdrawal syndrome in the emergency department.
To compare a phenobarbital-adjunct versus benzodiazepine-only approach for the management of alcohol withdrawal syndrome in the emergency department (ED) with regard to the need for intensive care unit (ICU) admission, severity of symptoms on ED discharge, and complications. ⋯ Adjunctive phenobarbital use in the ED for alcohol withdrawal syndrome did not result in decreased ICU admission, severity of symptoms, or complications.
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Randomized Controlled Trial Multicenter Study Comparative Study
Early Sedation with Dexmedetomidine in Critically Ill Patients.
Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU). The use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilation has not been extensively studied. ⋯ Among patients undergoing mechanical ventilation in the ICU, those who received early dexmedetomidine for sedation had a rate of death at 90 days similar to that in the usual-care group and required supplemental sedatives to achieve the prescribed level of sedation. More adverse events were reported in the dexmedetomidine group than in the usual-care group. (Funded by the National Health and Medical Research Council of Australia and others; SPICE III ClinicalTrials.gov number, NCT01728558.).
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Randomized Controlled Trial Multicenter Study Retracted Publication
A multicentre randomised controlled trial of the effect of intra-operative dexmedetomidine on cognitive decline after surgery.
Dexmedetomidine may reduce post-operative delirium and at one month post-operative cognitive decline in elderly patients, associated with changes in brain-derived neurotrophic factor.
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