ICU sedation - Revision history

Rossdonaldson1: /* See Also */

2022-03-29T20:24:50Z

Nora191star: /* Agents */

2022-03-17T00:00:34Z

Agents

← Older revision		Revision as of 00:00, 17 March 2022
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	**[[Midazolam]]		**[[Midazolam]]
	**[[Lorazepam]]		**[[Lorazepam]]
	*[[Dexmedetomidine]]		*[[Dexmedetomidine]] → useful as adjunct treatment for severe alcohol withdrawal in the ICU; associated with a reduction in short-term alcohol withdrawal symptoms in ICU patients<ref>Beg, M., Fisher, S., Siu, D., Rajan, S., Troxell, L., & Liu, V. X. (2016). Treatment of Alcohol Withdrawal Syndrome with and without Dexmedetomidine. The Permanente journal, 20(2), 49–53. https://doi.org/10.7812/TPP/15-113</ref>
	*[[Ketamine]]		*[[Ketamine]]
	*[[Haloperidol]]		*[[Haloperidol]]

Nora191star: /* Monitoring of Sedation */

2022-02-22T21:34:58Z

Monitoring of Sedation

← Older revision		Revision as of 21:34, 22 February 2022
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	**Decreases O2 consumption		**Decreases O2 consumption
	**Decrease intracranial pressure		**Decrease intracranial pressure
			*For intubated and mechanically ventilated patients who are unable to clearly communicate the source of agitation, analgesia should always be provided first<ref>https://journals.lww.com/ccmjournal/Fulltext/2018/09000/Clinical_Practice_Guidelines_for_the_Prevention.29.aspx</ref>

	==Agents==		==Agents==
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	*Several sedation monitoring scales are validated		*Several sedation monitoring scales are validated
	*Richmond Agitation and Sedation Scale (RASS) most commonly used ([http://ccn.aacnjournals.org/content/23/2/25/T3.large.jpg RASS])		*Richmond Agitation and Sedation Scale (RASS) most commonly used ([http://ccn.aacnjournals.org/content/23/2/25/T3.large.jpg RASS])
			*The [https://doi.org/10.1002/ejp.880 COMFORT scale] is a valid and reliable system for assessing sedation, distress, and pain in nonverbal pediatric patients

	==Considerations==		==Considerations==

Mholtz at 20:19, 31 December 2016

2016-12-31T20:19:20Z

← Older revision		Revision as of 20:19, 31 December 2016
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	*Sedation is commonly used for ICU patients		*Sedation is commonly used for ICU patients
	*Agent choice determined by side effect profile and disease process		*Agent choice determined by side effect profile and disease process
	~~===Uses===~~		*Common ICU uses
	*~~Can control~~ agitation		**Control agitation
	*~~Improves~~ patient-ventilator synchrony		**Improve patient-ventilator synchrony
	**Optimized oxygenation		**Decreases O2 consumption
	**Decrease peak pressures, breath stacking		**Decrease intracranial pressure
	*Decreases O2 consumption
	*Decrease intracranial pressure ~~in neurosurgical patients~~

	==Agents==		==Agents==
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	*[[Dexmedetomidine]]		*[[Dexmedetomidine]]
	*[[Ketamine]]		*[[Ketamine]]
	*[[Haloperidol]] ~~and other tranquilizers~~		*[[Haloperidol]]

	==Adverse Effects==		==Adverse Effects==
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	**Arrhythmias		**Arrhythmias

	==Monitoring==		==Monitoring of Sedation==
	*Several sedation monitoring scales are validated		*Several sedation monitoring scales are validated
	*Richmond Agitation and Sedation Scale most commonly used ([http://ccn.aacnjournals.org/content/23/2/25/T3.large.jpg RASS])		*Richmond Agitation and Sedation Scale (RASS) most commonly used ([http://ccn.aacnjournals.org/content/23/2/25/T3.large.jpg RASS])
	**Lighter sedation associated with shorter ICU stay, decreased time on ventilator<ref>
	Jacobi, J., Fraser, G. L., Coursin, D. B., Riker, R. R., Fontaine, D., Wittbrodt, E. T., Chalfin, D. B., Masica, M. F., Bjerke, S. H., Coplin, W. M., Crippen, D. W., Fuchs, B. D., Kelleher, R. M., Marik, P. E., Nasraway, S. A., Murray, M. J., Peruzzi, W. T. and Lumb, P. D. (2002) ‘Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult’, Critical Care Medicine, 30(1), pp. 119–141.</ref>

	==Considerations==		==Considerations==
			*Lighter sedation associated with shorter ICU stay, decreased time on ventilator<ref>
			Jacobi, J., Fraser, G. L., Coursin, D. B., Riker, R. R., Fontaine, D., Wittbrodt, E. T., Chalfin, D. B., Masica, M. F., Bjerke, S. H., Coplin, W. M., Crippen, D. W., Fuchs, B. D., Kelleher, R. M., Marik, P. E., Nasraway, S. A., Murray, M. J., Peruzzi, W. T. and Lumb, P. D. (2002) ‘Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult’, Critical Care Medicine, 30(1), pp. 119–141.</ref>
	*Deeper sedation associated with prolonged ICU stay, increased 6 month mortality<ref>Shehabi, Y., Bellomo, R., Reade, M. C., Bailey, M., Bass, F., Howe, B., McArthur, C., Seppelt, I. M., Webb, S. and Weisbrodt, L. (2012) ‘Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients’, American Journal of Respiratory and Critical Care Medicine, 186(8), pp. 724–731.</ref>		*Deeper sedation associated with prolonged ICU stay, increased 6 month mortality<ref>Shehabi, Y., Bellomo, R., Reade, M. C., Bailey, M., Bass, F., Howe, B., McArthur, C., Seppelt, I. M., Webb, S. and Weisbrodt, L. (2012) ‘Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients’, American Journal of Respiratory and Critical Care Medicine, 186(8), pp. 724–731.</ref>
	*Dexmedetomidine or propofol sedation may reduce ICU stay, time on ventilator, when compared with benzodiazepines<ref>Fraser, G. L., Devlin, J. W., Worby, C. P., Alhazzani, W., Barr, J., Dasta, J. F., Kress, J. P., Davidson, J. E. and Spencer, F. A. (2013) ‘Benzodiazepine Versus Nonbenzodiazepine-Based Sedation for Mechanically Ventilated, Critically Ill Adults’, Critical Care Medicine, 41pp. 30–38.</ref>		*Dexmedetomidine or propofol sedation may reduce ICU stay, time on ventilator, when compared with benzodiazepines<ref>Fraser, G. L., Devlin, J. W., Worby, C. P., Alhazzani, W., Barr, J., Dasta, J. F., Kress, J. P., Davidson, J. E. and Spencer, F. A. (2013) ‘Benzodiazepine Versus Nonbenzodiazepine-Based Sedation for Mechanically Ventilated, Critically Ill Adults’, Critical Care Medicine, 41pp. 30–38.</ref>

Ostermayer: Text replacement - "Category:Drugs" to "Category:Pharmacology"

2016-03-22T15:52:46Z

Text replacement - "Category:Drugs" to "Category:Pharmacology"

← Older revision		Revision as of 15:52, 22 March 2016
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	[[Category:Critical Care]]		[[Category:Critical Care]]
	[[Category:~~Drugs~~]]		[[Category:Pharmacology]]

Kian: added sedation uses

2015-06-18T20:06:14Z

added sedation uses

← Older revision		Revision as of 20:06, 18 June 2015
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	*Can control agitation		*Can control agitation
	*Improves patient-ventilator synchrony		*Improves patient-ventilator synchrony
			**Optimized oxygenation
			**Decrease peak pressures, breath stacking
	*Decreases O2 consumption		*Decreases O2 consumption
	*Decrease intracranial pressure in neurosurgical patients		*Decrease intracranial pressure in neurosurgical patients

Rossdonaldson1 at 18:19, 18 June 2015

2015-06-18T18:19:49Z

← Older revision		Revision as of 18:19, 18 June 2015
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	*Decreases O2 consumption		*Decreases O2 consumption
	*Decrease intracranial pressure in neurosurgical patients		*Decrease intracranial pressure in neurosurgical patients

	~~{{Sedative agents}}~~

	==Agents==		==Agents==

Rossdonaldson1 at 18:18, 18 June 2015

2015-06-18T18:18:51Z

← Older revision		Revision as of 18:18, 18 June 2015
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	*Decreases O2 consumption		*Decreases O2 consumption
	*Decrease intracranial pressure in neurosurgical patients		*Decrease intracranial pressure in neurosurgical patients

			{{Sedative agents}}

	==Agents==		==Agents==

Rossdonaldson1: Rossdonaldson1 moved page ICU Sedation to ICU sedation

2015-06-18T18:10:27Z

Rossdonaldson1 moved page ICU Sedation to ICU sedation

← Older revision	Revision as of 18:10, 18 June 2015
(No difference)

Rossdonaldson1 at 04:42, 18 June 2015

2015-06-18T04:42:07Z

← Older revision		Revision as of 04:42, 18 June 2015
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	*Dexmedetomidine or propofol sedation may reduce ICU stay, time on ventilator, when compared with benzodiazepines<ref>Fraser, G. L., Devlin, J. W., Worby, C. P., Alhazzani, W., Barr, J., Dasta, J. F., Kress, J. P., Davidson, J. E. and Spencer, F. A. (2013) ‘Benzodiazepine Versus Nonbenzodiazepine-Based Sedation for Mechanically Ventilated, Critically Ill Adults’, Critical Care Medicine, 41pp. 30–38.</ref>		*Dexmedetomidine or propofol sedation may reduce ICU stay, time on ventilator, when compared with benzodiazepines<ref>Fraser, G. L., Devlin, J. W., Worby, C. P., Alhazzani, W., Barr, J., Dasta, J. F., Kress, J. P., Davidson, J. E. and Spencer, F. A. (2013) ‘Benzodiazepine Versus Nonbenzodiazepine-Based Sedation for Mechanically Ventilated, Critically Ill Adults’, Critical Care Medicine, 41pp. 30–38.</ref>
	**SCCM Recommendation, level 2B (weak recommendation)<ref>Barr, J., Fraser, G. L., Puntillo, K., Ely, W. E., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., Coursin, D. B., Herr, D. L., Tung, A., Robinson, B. R. H., Fontaine, D. K., Ramsay, M. A., Riker, R. R., Sessler, C. N., Pun, B., Skrobik, Y. and Jaeschke, R. (2013) ‘Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit’, Critical Care Medicine, 41(1), pp. 278–280.</ref>		**SCCM Recommendation, level 2B (weak recommendation)<ref>Barr, J., Fraser, G. L., Puntillo, K., Ely, W. E., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., Coursin, D. B., Herr, D. L., Tung, A., Robinson, B. R. H., Fontaine, D. K., Ramsay, M. A., Riker, R. R., Sessler, C. N., Pun, B., Skrobik, Y. and Jaeschke, R. (2013) ‘Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit’, Critical Care Medicine, 41(1), pp. 278–280.</ref>

			==See Also==
			*[[Sedation (Main)]]

	==References==		==References==
	<references/>		<references/>

	~~==See Also==~~
	*[[Sedation (Main)]]

	[[Category:Critical Care]]		[[Category:Critical Care]]
	[[Category:Drugs]]		[[Category:Drugs]]

← Older revision		Revision as of 20:24, 29 March 2022
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	==See Also==		==See Also==
	*[[Sedation (~~Main~~)]]		*[[Sedation (main)]]

	==References==		==References==