scholarly journals 276: IMPACT OF A SEDATION AND ANALGESIA WEANING PROTOCOL IN CRITICALLY ILL PATIENTS WITH COVID-19

2021 ◽  
Vol 50 (1) ◽  
pp. 123-123
Author(s):  
Stephanie Seto ◽  
Natasha Lopez ◽  
Arzo Hamidi ◽  
Russel Roberts ◽  
Kristy Phillips
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Sedation And Analgesia

scholarly journals Selection strategy for sedation depth in critically ill patients on mechanical ventilation

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Longxiang Su ◽  
Chun Liu ◽  
Fengxiang Chang ◽  
Bo Tang ◽  
Lin Han ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dimensionality Reduction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation And Analgesia ◽  
Ventilated Patients

Abstract Background Analgesia and sedation therapy are commonly used for critically ill patients, especially mechanically ventilated patients. From the initial nonsedation programs to deep sedation and then to on-demand sedation, the understanding of sedation therapy continues to deepen. However, according to different patient’s condition, understanding the individual patient’s depth of sedation needs remains unclear. Methods The public open source critical illness database Medical Information Mart for Intensive Care III was used in this study. Latent profile analysis was used as a clustering method to classify mechanically ventilated patients based on 36 variables. Principal component analysis dimensionality reduction was used to select the most influential variables. The ROC curve was used to evaluate the classification accuracy of the model. Results Based on 36 characteristic variables, we divided patients undergoing mechanical ventilation and sedation and analgesia into two categories with different mortality rates, then further reduced the dimensionality of the data and obtained the 9 variables that had the greatest impact on classification, most of which were ventilator parameters. According to the Richmond-ASS scores, the two phenotypes of patients had different degrees of sedation and analgesia, and the corresponding ventilator parameters were also significantly different. We divided the validation cohort into three different levels of sedation, revealing that patients with high ventilator conditions needed a deeper level of sedation, while patients with low ventilator conditions required reduction in the depth of sedation as soon as possible to promote recovery and avoid reinjury. Conclusion Through latent profile analysis and dimensionality reduction, we divided patients treated with mechanical ventilation and sedation and analgesia into two categories with different mortalities and obtained 9 variables that had the greatest impact on classification, which revealed that the depth of sedation was limited by the condition of the respiratory system.

Sedation and analgesia in the critically ill

2010 ◽  
pp. 3153-3157
Author(s):  
Gilbert Park ◽  
Maire P. Shelly
Keyword(s):  
Pain Relief ◽  
Critically Ill ◽  
Tracheal Tube ◽  
Critically Ill Patients ◽  
Hepatic Failure ◽  
Half Life ◽  
Enzyme System ◽  
Onset Of Action ◽  
Fast Onset ◽  
Sedation And Analgesia

Nearly all critically ill patients need analgesia, anxiolysis, hypnosis, or measures to help them tolerate their tracheal tube. Although making the patient unconscious may appear the easiest way to achieve this, it is fraught with hazards. Pain relief and tube tolerance—these are the first priority, and usually involves giving opioids. Morphine, which has both analgesic and sedative effects, is the opioid against which others are judged. Remifentanil is a relatively new agent that has properties useful in critically ill patients: fast onset of action, a predictable short half-life (10–21 min), and it is broken down by a nonspecific enzyme system present in plasma such that accumulation does not occur, and the drug wears off rapidly, even after prolonged infusions and in renal or hepatic failure....

Sedation and Analgesia

2015 ◽  
pp. 278-312
Author(s):  
Jordan Brand
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Experimental Evidence ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Effects ◽  
Hemodynamic Characteristics ◽  
Pain And Suffering ◽  
Sedation And Analgesia

Patients in the cardiothoracic intensive care unit (CTICU) are subject to numerous physical and mental stresses. While most of these cannot be completely eliminated, intensivists have many tools in their armamentarium to alleviate patients' pain and suffering. This chapter will consider the importance of analgesia and sedation in the CTICU and the relevant consequences of over- or under-treatment. We will examine the tools available for monitoring and titrating analgesia and sedation in critically ill patients. The major classes of medications available will be reviewed, with particular attention to their clinical effects, metabolism and excretion, and hemodynamic characteristics. Lastly, experimental evidence will be assessed regarding the best strategies for treatment of pain and agitation in the CTICU, including use of non-pharmacologic adjuvants.

Sedation and Analgesia in Transportation of Acutely and Critically Ill Patients

2016 ◽  
Vol 28 (2) ◽  
pp. 137-154
Author(s):  
Dawn Johnston ◽  
Kevin Franklin ◽  
Paul Rigby ◽  
Karen Bergman ◽  
Scott B. Davidson
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Sedation And Analgesia

scholarly journals Sedation and Analgesia

2017 ◽  
pp. 486-519
Author(s):  
Jordan Brand
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Experimental Evidence ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Effects ◽  
Hemodynamic Characteristics ◽  
Pain And Suffering ◽  
Sedation And Analgesia

Patients in the cardiothoracic intensive care unit (CTICU) are subject to numerous physical and mental stresses. While most of these cannot be completely eliminated, intensivists have many tools in their armamentarium to alleviate patients' pain and suffering. This chapter will consider the importance of analgesia and sedation in the CTICU and the relevant consequences of over- or under-treatment. We will examine the tools available for monitoring and titrating analgesia and sedation in critically ill patients. The major classes of medications available will be reviewed, with particular attention to their clinical effects, metabolism and excretion, and hemodynamic characteristics. Lastly, experimental evidence will be assessed regarding the best strategies for treatment of pain and agitation in the CTICU, including use of non-pharmacologic adjuvants.

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