Washout and Awakening Times after Inhaled Sedation of Critically Ill Patients: Desflurane Versus Isoflurane

In recent years, inhaled sedation has been increasingly used in the intensive care unit (ICU). The aim of this prospective, controlled trial was to compare washout and awakening times after long term sedation with desflurane and isoflurane both administered with the Mirus™ system (TIM GmbH, Koblenz, Germany). Twenty-one consecutive critically ill patients were alternately allocated to the two study groups, obtaining inhaled sedation with either desflurane or isoflurane. After 24 h study sedation, anesthetic washout curves were recorded, and a standardized wake-up test was performed. The primary outcome measure was the time required to decrease the endtidal concentration to 50% (T50%). Secondary outcome measures were T80% and awakening times (all extremities moved, RASS −2). Decrement times (min) (desflurane versus isoflurane, median (1st quartile—3rd quartile)) (T50%: 0.3 (0.3–0.4) vs. 1.3 (0.4–2.3), log-rank test P = 0.002; P80%: 2.5 (2–5.9) vs. 12.1 (5.1–20.2), P = 0.022) and awakening times (to RASS −2: 7.5 (5.5–8.8) vs. 41.0 (24.5–43.0), P = 0.007; all extremities moved: 5.0 (4.0–8.5) vs. 13.0 (8.0–41.25), P = 0.037) were significantly shorter after desflurane compared to isoflurane. The use of desflurane with the Mirus™ system significantly shortens the washout times and leads to faster awakening after sedation of critically ill patients.

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Efficacy of recombinant human erythropoietin in critically ill patients admitted to a long-term acute care facility: A randomized, double-blind, placebo-controlled trial*

Critical Care Medicine ◽

10.1097/01.ccm.0000233873.17954.42 ◽

2006 ◽

Vol 34 (9) ◽

pp. 2310-2316 ◽

Cited By ~ 58

Author(s):

Michael Silver ◽

Michael J. Corwin ◽

Andrea Bazan ◽

Andrew Gettinger ◽

Christopher Enny ◽

...

Keyword(s):

Critically Ill ◽

Acute Care ◽

Critically Ill Patients ◽

Recombinant Human Erythropoietin ◽

Controlled Trial ◽

Care Facility ◽

Double Blind ◽

Double Blind Placebo ◽

Human Erythropoietin

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Efficacy of recombinant human erythropoietin in critically ill patients admitted to a long-term acute care facility: A randomized, double-blind, placebo-controlled trial

Yearbook of Critical Care Medicine ◽

10.1016/s0734-3299(08)70590-2 ◽

2008 ◽

Vol 2008 ◽

pp. 227-229

Author(s):

C. Bekes

Keyword(s):

Critically Ill ◽

Acute Care ◽

Critically Ill Patients ◽

Recombinant Human Erythropoietin ◽

Controlled Trial ◽

Care Facility ◽

Double Blind ◽

Double Blind Placebo ◽

Human Erythropoietin

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Non-sedation versus sedation with a daily wake-up trial in critically ill patients recieving mechanical ventilation - effects on long-term cognitive function: Study protocol for a randomized controlled trial, a substudy of the NONSEDA trial

Trials ◽

10.1186/s13063-016-1390-5 ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 5

Author(s):

Helene Korvenius Nedergaard ◽

Hanne Irene Jensen ◽

Mette Stylsvig ◽

Jørgen T. Lauridsen ◽

Palle Toft

Keyword(s):

Mechanical Ventilation ◽

Randomized Controlled Trial ◽

Cognitive Function ◽

Critically Ill ◽

Study Protocol ◽

Critically Ill Patients ◽

Controlled Trial ◽

Randomized Controlled ◽

Function Study

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Efficacy and tolerability of various bowel preparations in diabetic patients: a randomized controlled trial

Endoscopy International Open ◽

10.1055/a-0650-3908 ◽

2018 ◽

Vol 06 (10) ◽

pp. E1157-E1163

Author(s):

Mohammad F. Madhoun ◽

Khadija K. Chaudrey ◽

Sian S. Chisholm ◽

Aftab Ahmed ◽

Belinda Frost ◽

...

Keyword(s):

Bowel Preparation ◽

Controlled Trial ◽

Study Groups ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Diabetic Patients ◽

Split Dose ◽

Stimulant Laxative ◽

Patients With Diabetes

Abstract Background and study aims Diabetes mellitus (DM) is an independent risk factor for poor bowel preparation prior to colonoscopy. Bisacodyl is a stimulant laxative that may mitigate colonic dysmotility associated with diabetes. We hypothesized that adding bisacodyl to split-dose bowel preparation (SDBP) would improve the quality of bowel preparation among patients with diabetes. Patients and methods Adult outpatients aged 18 to 80 years undergoing colonoscopy were recruited. One hundred and eighty-six patients with diabetes were randomly assigned to 1 of 3 treatment arms: 1) conventional 4 L of polyethylene glycol electrolyte lavage solution (PEG-ELS; conventional bowel preparation [CBP]); 2) split-dose of 4 L PEG-ELS (split-dose bowel preparation [SDBP]); or 3) split-dose of 4 L PEG-ELS preceded by 10 mg of oral bisacodyl 10 (SDBP-B). The primary outcome measure was bowel cleansing as indicated by Boston Bowel Preparation Scale (BBPS) score. Endoscopists were blinded to the preparation used. Secondary outcome measures were safety and patient tolerability. Results Of the 212 patients randomized, only 186 received assigned bowel preparation. There were no differences among the three study groups with regard to age, indication, duration of DM, insulin use, narcotic use, or presence of end-organ diabetic complications. There was a trend toward better bowel preparation quality among those receiving SDBP and SDBP-B compared to those receiving CBP, but the trend was not statistically significant ≥ 6 BBPS; 67 % vs. 83 % vs. 75 %, P = 0.1). In terms of safety and tolerability, there were no differences among the three groups. Conclusion Adding bisacodyl to SDBP does not improve the quality of bowel preparation in patients with DM. Further efforts are needed to optimize colonoscopy bowel preparation in this population.

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Efficacy And Safety of Family Participate In The Early Mobilization of Critically Ill Patients: Study Protocol For A Randomized Controlled Trial

10.21203/rs.3.rs-78247/v1 ◽

2021 ◽

Author(s):

Yuchen Wu ◽

Guoqiang Wang ◽

Bin Li ◽

Huaping Wei ◽

Zhigang Zhang ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Controlled Trial ◽

Early Mobilization ◽

Icu Patients ◽

Outcome Indicators ◽

Randomized Controlled ◽

Hospitalization Costs ◽

Mechanical Ventilation Time

Abstract Background：Long-term immobilization can cause a series of harm to ICU patients, while early rehabilitation can effectively reduce the harm of long-term immobilization and improve the medical outcome of patients. Can family members participate in the early mobilization (FMPiEM) of critically ill patients? Whether the FMPiEM of critically ill patients can reduce delirium, anxiety, depression, post-traumatic stress syndrome and other adverse emotions of ICU patients.Objective: To explore the FMPiEM of critically ill patients on the short-term and long-term outcomes.Methods and design: A single-center randomized controlled trial (RCT) is conducted and reported according to the CONSORT guidelines. A total of 120 samples were randomly assigned to the intervention group (FMPiEM) and the control group ( without-FMPiEM).The primary outcome indicators included the incidence of ICU delirium, acquired infection, ICU mortality, and ICU-acquired weakness (ICU-AW), while the secondary outcome indicators included mechanical ventilation time, length of stay in ICU (ICU LOS), reintubation, unplanned extubation (UEX), hospitalization costs, and patient outcomes. SPSS 22.0 software was used for statistical analysis. Frequency and mean ± standard deviation were used for descriptive analysis. B test, t test or Mann-whitney U test were used for statistical inference.Discussion: FMPiEM of critically ill patients maybe not only reduce the incidence of delirium, ICU-AW, but also reduce the mechanical ventilation time, length of stay in ICU, reintubation, UEX and hospitalization costs of critically ill patients, at the same time, without increasing the acquired infection in ICU.Trial registration: Chinese Clinical Trial Registry, ID:ChiCTR2000028902. Registered on 06 January 2020.

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