Feasibility of using a non-sedation protocol for evaluation of neonatal congenital heart disease by using a 16-cm wide-detector computed tomography with a low radiation dose: preliminary experience from a single pediatric medical center
Chen GuoYujie LiuAimin SunRongzhen OuyangLiwei HuWei‐Hui XieHaisheng QiuHaibo ZhangZhuoming XuJiaqi SunYumin ZhongQian Wang
1
Citation
17
Reference
10
Related Paper
Citation Trend
Analgesia and sedation play important roles in the overall treatment of critically burned adult patients. According to clinical actual situation of critically burned adult patients, a set of analgesic and sedative practices, including analgesia-based sedation, scientifically reasonable sedation status monitoring, early goal-directed sedation strategy, standardized and individualized strategy for analgesia and sedation, and early comfort using analgesia, minimal sedative, maximal human care strategy are recommended and widely implemented nowadays. However, guideline or consensus about how to provide analgesia and sedation treatment for critically burned adult patients is lacking. In this article, we discuss strategy for analgesic and sedative management in critically burned adult patients, with preexisting ideas in critical care medicine, pathophysiological characteristics of critically burned patients, and our clinical practice for reference.
Guideline
Cite
Citations (0)
There is a need for assessment of sedation in ICU as sedative agents are potent drugs that are used frequently but not regularly monitored for their efficacy. Critical care nurses are accountable when administering potent intravenous drugs, such as sedative agents. This paper examines the rationale behind the use of sedation in ICU. A number of sedative drugs commonly used in ICU, such as propofol, are highlighted. Sedation assessment tools available are considered but each may be appropriate in different situations.
Cite
Citations (9)
The aim of this study is to evaluate the issues of sedation and analgesia in all-purpose ICUs in Russia. To obtain that, a single-day observational survey was performed in 55 ICUs of Ural and Siberia regions. This work enabled to describe the targets, instruments of control and patterns of sedative and analgetics and sedatives prescription, as well as to make conclusions about issues in this area and possibilities of creation and necessity of analgesia and sedation standards. The study has shown a decent percentage of use of standardized scales evaluating pain in ICU and predominance of effectivae drugs and analgesia patterns, which leads to "formalization" of analgesia and decrease of it's effectiveness. Sedation indications do not satisfy the modern concept, sedation level evaluation scores are used only in 13%, schemes and drugs are traditional. The results of this study may serve as a reason for discussion of necessity of introducing of sedative and analgetic therapy in ICU standarts.
Cite
Citations (0)
Anterograde amnesia
Cite
Citations (25)
A national survey of members of the American Academy of Pediatric Dentistry was conducted to provide a 15-year update of information regarding the use of sedative agents by pediatric dentists.All 3,315 active members of the Academy were sent questionnaires regarding the frequency of their use of sedation and 1,778 responded. Practitioners were questioned regarding their use of sedative agents and the nature of their patients receiving sedation. In addition, they were questioned in regard to their use of restraints and reasons for change in their use of sedation during the past two years.In regard to the use of nitrous oxide alone, 47% of practitioners responded that they use nitrous oxide less than 11% of the time. In regard to other types of sedative agents, most practitioners use little, if any, sedation. Eighty-two percent use sedation for less than 11% of their patients. Of the 1,778 respondents, 1,224 used drugs other than nitrous oxide. In a typical three-month period, they performed 77,112 sedations. Of that number, 61,662 (80%) were administered by only 478 practitioners who use sedation on the average of once or greater each day.In comparison with previous surveys in 1985, 1991 and 1995, these results demonstrate an overall increased use of sedation by pediatric dentists. However, the increased use is due primarily to an increase in the numbers of practitioners who are heavier users of sedation (once or greater each day).
Nitrous oxide
Cite
Citations (96)
Objective To explore the sedative effects of dexmedetomidine as a ward-based sedation on ventilated patients in intensive care unit.Methods Forty ventilated patients were divided into midazolam group(group A) and midazolam+ dexmedetomidine group(group B),with 20 patients in each group.Recorded the APACHE Ⅱ score,Ramsay score and PaO2/FiO2 indicators before sedation.Heart rate,blood pressure and respiration were recorded at 4h,6h and 12h of sedation.The infusion were ceased after 12h,then the sedative degree was assessed every 30 min,recover time,time to achieve satisfactory sedation and the sedation level were recorded.Results 90% of patients could achieve satisfactory sedation using dexmedetomidine alone,if the joint use of midazolam has only very low doses.The midazolam dosage,time to achieve satisfactory sedation and recover time in group B decreased significantly than those in Group A (P0.05).Satisfactory degree of sedation in group B were higher than those in group A(P0.05).Conclusion In medical ventilated patients,dexmedetomidine can improve the sedative efect of midazolam.
Dexmedetomidine
Midazolam
Cite
Citations (1)
Dexmedetomidine
Depression
Cite
Citations (14)
Background: The use of sedation at the end of life has aroused ethical controversy, attracting accusations of hastening death by gradually increasing sedative doses.The doctrine of double effect has been introduced as an ethical defense.This study aimed to determine how sedative doses change at the end of life and how often the doctrine of double effect might be relevant.Methods: Case note review was performed of 237 consecutive patients who died in a specialist palliative care unit.Sedative dose changes during the last week of life were noted and survival from admission was compared between groups of patients receiving no sedation, sedation for 7 days, or a commencement of sedation in the last 48 hours of life.There was detailed review of notes from patients who received a marked increase in sedative dose to explore the applicability of the doctrine of double effect.Results: Sedation was given to 48% of patients.Of these, 13% received sedatives for 7 days or more, while 56% commenced sedative use only in the last 48 hours of life.The groups receiving no sedation or sedation for less than 48 hours had the shortest survival from admission (mean, 14.3 and 14.2 days), whereas the 7-day sedation group survived for a mean of 36.6 days (PϽ.001).Sedative use and dose increased toward the end of life, but the detailed case note review disclosed only 2 cases where the doctrine of double effect may have been implicated. Conclusion:Sedative dose increases in the last hours of life were not associated with shortened survival overall, suggesting that the doctrine of double effect rarely has to be invoked to excuse sedative prescribing in endstage care.
Cite
Citations (294)
Objective The effect and safety of short-course intensive sedative therapy for post-operative spontaneous intracerebral hemorrhage are discussed. Methods The patients were divided into intensive sedation group with sedative target for Riker sedation-agitation scale( SAS) 1 ~2 and traditional sedation group with sedative target for SAS 3 ~4,respectively. All patients received sedation therapy for no more than 12 h. Results Compared with the traditional sedation group,sedation of 12 h post-operation in short-course intensive sedation group was deep and long; the systolic pressure and diastolic pressure in 12 h post-operation was low and the volume of residual hematoma at 2 d post-operation was less. Meanwhile ICU hospitalization of short-course intensive sedation group did not prolong and the incidence of ventilator-associated pneumonia( VAP) was not increased. Conclusion Shortcourse intensive sedative therapy is effective and safe for post-operative spontaneous intracerebral hemorrhage.
Cite
Citations (0)
Objective To observe the sedative effect of dexmedetomidine on the patients with Cerebral Lesions in ICU.Methods Dexmedetomidine is given by continuous infusion following a load dose to provide satifactory sedation in 50 patients with Cerebral Lesions.Maintain Ramsay score 2 ～ 5 points.Results The sedation efficiency was(86.6 ± 7.3) %.The average infusion rate of midazolam during the sedative period was (0.52 +0.13) μg/(kg·h),while the signs of life remained stable.Conclusion Dexmedetomidine can provide satisfactory sedation and unique advantage for ICU patients.
Dexmedetomidine
Midazolam
Continuous Infusion
Cite
Citations (0)