The use of sedatives, opioids, and neuromuscular blocking agents (NMBAs) may delay weaning prolong intensive care unit length stay. We hypothesized that in patients on higher positive end-expiratory pressure (PEEP), NMBAs are used a proportion doses the these medications is associated with prolongation mortality.Retrospective analysis.The ALVEOLI trial.Five hundred forty-nine acute lung injury/acute respiratory distress syndrome (ALI/ARDS) who were enrolled trial.We analyzed prospectively...

Objectives: The primary objective was to evaluate the relationship between high-dose lorazepam and serum propylene glycol concentrations. Secondary objectives were a) document occurrence of accumulation associated with continuous infusion; b) assess dose, concentrations, accumulation; c) osmol gap Design: Prospective, observational study. Setting: Tertiary care, medical intensive care unit. Patients: Nine critically ill adults receiving (≥10 mg/hr) infusion. Interventions: Cumulative dose...

To investigate the efficacy, safety, pharmacodynamics, and pharmacokinetics of liposomal bupivacaine (LB) administered via ultrasound-guided sciatic nerve block in popliteal fossa participants undergoing bunionectomy. Two-part, randomized, double-blind, active-controlled trial (NCT05157841). Operating room, postanesthesia care unit, health facility (6 sites). Adults with American Society Anesthesiologists physical status classification ≤3 body mass index ≥18 to <40 kg/m2 elective distal...

The rate of continuation antipsychotics for the management delirium during hospital transitions care in a tertiary medical center was investigated.A retrospective chart review conducted adult patients admitted to intensive unit (MICU) between June 1, 2011, and May 31, 2012, who were initiated on antipsychotic therapy at least 24 hours before transfer out MICU. primary outcome evaluated percentage an MICU continued after ward. Secondary outcomes included appropriateness continuing...

Introduction Erector spinae plane (ESP) blocks can be used to provide analgesia following thoracoabdominal and lumbar spine surgical procedures. However, the influence of injectate volume injection location on spread anesthetic with ESP remain unclear. Methods Ultrasound-guided injections were performed two fresh cadavers using a solution iopamidol radiographic contrast, indocyanine green or methylene blue dye, saline. The relationship between cephalocaudal was assessed real-time...

Plain Language SummaryWhat is this summary about?This a of phase 3 clinical trial that compared the pain medication liposomal bupivacaine (LB), specific form common numbing designed to extend control after injection, with hydrochloride (BUPI) in people who underwent bunionectomy, type foot surgeryHow was study conducted?People received treatment (referred as 'patients' rest plain language summary) either LB or BUPI an injection at spot back knee where nerves are located (called popliteal...

Extended-infusion ceftolozane-tazobactam treatment at 1.5 g every 8 h was used to treat multidrug-resistant Pseudomonas aeruginosa in a critically ill patient on continuous venovenous hemofiltration. Serum drug concentrations were measured 1, 4, 5, 6, and after the start of infusion. Prefilter levels ceftolozane produced maximum concentration (Cmax) 38.57 μg/ml, end dosing interval (Cmin) 31.63 time Cmax (Tmax) 4 h, area under concentration-time curve from 0 (AUC0-8) 284.38 μg · h/ml,...

To report a case of amlodipine overdose successfully treated with intravenous lipid emulsion (ILE).

Introduction: Delirium affects a large proportion of patients admitted to the intensive care unit (ICU) and is associated with increased morbidity mortality. Antipsychotics have become frequently used agents for treatment delirium; however, they are often continued at transitions care. This has potential negative short- long-term health consequences that preventable. We investigated antipsychotic tapering bundle’s impact on rate continuation from medical (MICU). Methods: was preretrospective...

Abstract Objective To determine the rate of compliance to 2006 and 2009 ADA DKA guidelines in medical intensive care unit (MICU) at a large academic centre after implementation computerised order set protocol. Methods Retrospective chart review adult patients with admitted MICU. Results pre-order (PRE) were compared those data post-order (POST). The primary outcome was composite administration intravenous fluid resuscitation first 24 h, insulin bolus initial infusion rate. Key findings...

Obese patients with sepsis or septic shock may have altered vancomycin pharmacokinetics compared the general population that result in improper dosing inadequate drug concentrations. The objective of this study was to characterize obese shock, and develop a novel pharmacokinetic model based on pharmacokinetic-pharmacodynamic target requirements.Prospective observational study.Large quaternary academic medical center.Sixteen (body mass index [BMI] 30 kg/m2 higher) adults either gram-positive...

Opioids are one of the high-risk medication classes that administered to critically ill patients during their intensive care unit (ICU) stay. However, little attention has been given inpatient opioid prescribing practices, especially in patients. The purpose our study was characterize practices across 2 transitions an hospital stay: medical ICU (MICU)/intermediate (IMC) floor and discharge identify potential patient-specific factors impact continuation.This is a retrospective cohort...

Considering the difficulties following administration of nitrites (or aminophenols) or cobalt-EDTA as well ineffectivenes hydroxycobalamin and pyruvate, we feel that a more sensible treatment for acute cyanide intoxication is hemodialysis combined with intravenous sodium thiosulfate. The addition to such regimen helpful in three ways. First, it removes small extracellular reservoir cyanide, particularly if poison still being absorbed from gastrointestinal tract. Second, corrects severe...

To determine if treatment of DKA in a sample adult medical intensive care unit (MICU) patients was consistent with the 2006 ADA Hyperglycemic Crises Adult Patients Diabetes Clinical Guidelines.Medical records were reviewed for all admitted to MICU diagnosis between July 1, 2007 and June 30, 2010. The primary composite endpoint assessed fluid resuscitation (total mL/kg) at 24 hours, insulin bolus dose, continuous infusion (units/kg or units/kg/hour) whether clinical guidelines followed....

Purpose To assess the clinical impact of a vancomycin dosing protocol and monitoring tool on initial dose, interval, trough concentrations in adult medicine patients. Methods This was retrospective chart review patients who received at least one dose were admitted during pre-implementation period, February 1 to April 2009, or post-implementation June October 31, 2009. All outcomes for group compared those group. The primary frequency appropriate interval. secondary included concentrations,...