Articles: critical-illness.
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Randomized Controlled Trial
A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial.
Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. Daily interruption of sedation has a beneficial effect, and in the general intesive care unit of Odense University Hospital, Denmark, standard practice is a protocol of no sedation. We aimed to establish whether duration of mechanical ventilation could be reduced with a protocol of no sedation versus daily interruption of sedation. ⋯ Danish Society of Anesthesiology and Intensive Care Medicine, the Fund of Danielsen, the Fund of Kirsten Jensa la Cour, and the Fund of Holger og Ruth Hess.
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Critical care medicine · Jan 2010
Comment Letter Randomized Controlled Trial Comparative StudyRandomized trial of light versus deep sedation on mental health after critical illness.
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Blood Coagul. Fibrinolysis · Jan 2010
Randomized Controlled TrialLow-molecular-weight heparin and unfractionated heparin in prophylaxis against deep vein thrombosis in critically ill patients undergoing major surgery.
The objective of the present study was to compare the efficacy and safety of low-dose unfractionated heparin (UFH) and a low-molecular-weight heparin (LMWH) as prophylaxis against venous thromboembolism in critically ill surgical patients undergoing major surgery. This was a randomized prospective study in which critically ill patients scheduled to undergo major elective surgery were allocated to receive subcutaneously either LMWH once daily and a placebo injection containing sterile 0.9% normal saline or 5000 IU UFH twice daily subcutaneously. Each patient was evaluated postoperatively clinically and confirmed by Doppler study for development of deep vein thrombosis (DVT). ⋯ However, minor hemorrhagic complications such as wound hematoma and surgical site bleeding were significantly more in the heparin group as compared with the LMWH group. Both UFH 5000 units subcutaneously twice daily and LMWH 40 mg once daily provide highly effective and well tolerated prophylaxis for critically ill surgical patients. Considering the advantage of once-daily dosing, a wider adoption of prophylaxis with LMWH may be justified on the basis of patient acceptability and saving of nursing time.
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Randomized Controlled Trial Multicenter Study Comparative Study
Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial.
Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD. ⋯ The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.
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Randomized Controlled Trial Multicenter Study Comparative Study
A multi-center, randomized, double-blind, parallel, placebo-controlled trial to evaluate the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for the treatment of fever in critically ill and non-critically ill adults.
Hospitalized patients are often unable to ingest or tolerate oral antipyretics and recently an aqueous formulation of intravenous (IV) ibuprofen was approved by the US-FDA for the reduction of fever in adults. ⋯ All doses of IV ibuprofen tested reduced fever at four hours and throughout the first 24 hours of dosing. The 400 mg dose was effective in lowering temperature to normal and maintaining this over the first 24 hours of dosing. IV ibuprofen was effective in reducing fevers in critically ill and non-critically ill groups. Following 24 hours of administration of IV ibuprofen, no clinically significant differences in any safety parameter including renal function or bleeding occurred through the 28-day follow-up period.