A5015518427- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Cardiac Arrest and Resuscitation
- Anesthesia and Neurotoxicity Research
- Cardiac, Anesthesia and Surgical Outcomes
- Traumatic Brain Injury and Neurovascular Disturbances
- Sepsis Diagnosis and Treatment
- Respiratory Support and Mechanisms
- Pharmacological Effects and Toxicity Studies
- Thermal Regulation in Medicine
- Epilepsy research and treatment
- Trauma and Emergency Care Studies
- Family and Patient Care in Intensive Care Units
- Healthcare Decision-Making and Restraints
- Emergency and Acute Care Studies
- Traumatic Brain Injury Research
- Alcoholism and Thiamine Deficiency
- Hemodynamic Monitoring and Therapy
- Electrolyte and hormonal disorders
- Non-Invasive Vital Sign Monitoring
- Mechanical Circulatory Support Devices
- Heart Rate Variability and Autonomic Control
- Opioid Use Disorder Treatment
- Venous Thromboembolism Diagnosis and Management
- COVID-19 Clinical Research Studies
Maine Medical Center
2012-2025
Tufts University
2016-2025
Maine Medical Center
2016-2025
MaineHealth
2019-2025
National Heart Lung and Blood Institute
2023-2024
New England College
2023
Wilkes University
2023
University of New England
2023
Neurosciences Institute
2013-2022
Bridgepoint (United Kingdom)
2022
To update and expand the 2013 Clinical Practice Guidelines for Management of Pain, Agitation, Delirium in Adult Patients ICU.Thirty-two international experts, four methodologists, critical illness survivors met virtually at least monthly. All section groups gathered face-to-face annual Society Critical Care Medicine congresses; virtual connections included those unable to attend. A formal conflict interest policy was developed a priori enforced throughout process. Teleconferences electronic...
Jacobi, Judith PharmD, FCCM, BCPS; Fraser, Gilles L. FCCM; Coursin, Douglas B. MD; Riker, Richard R. Fontaine, Dorrie RN, DNSc, FAAN; Wittbrodt, Eric T. PharmD; Chalfin, Donald MD, MS, Masica, Michael F. MPH; Bjerke, H. Scott Coplin, William M. Crippen, David W. Fuchs, Barry D. Kelleher, Ruth RN; Marik, Paul E. MDBCh, Nasraway, Stanley A. Jr Murray, J. PhD, Peruzzi, Lumb, Philip MB, BS, FCCM. Author Information
<h3>Context</h3>γ-Aminobutyric acid receptor agonist medications are the most commonly used sedatives for intensive care unit (ICU) patients, yet preliminary evidence indicates that α<sub>2</sub> dexmedetomidine may have distinct advantages.<h3>Objective</h3>To compare efficacy and safety of prolonged sedation with vs midazolam mechanically ventilated patients.<h3>Design, Setting, Patients</h3>Prospective, double-blind, randomized trial conducted in 68 centers 5 countries between March 2005...
Objective Subjective scales to assess agitation and sedation in adult intensive care unit (ICU) patients have rarely been tested for validity or reliability. We revised prospectively the Sedation-Agitation Scale (SAS) interrater reliability compared it with Ramsay scale Harris test construct validity. Design A convenience sample of ICU was simultaneously independently examined by pairs trained evaluators using SAS, Ramsay, Scales. Setting Multidisciplinary 34-bed a nonuniversity, academic...
Objectives: To determine the relationship between number of delirium days experienced by intensive care patients and mortality, ventilation time, unit stay. Design: Prospective cohort analysis. Setting: Patients from 68 units in five countries. Patients: Three hundred fifty-four medical surgical enrolled SEDCOM (Safety Efficacy Dexmedetomidine Compared with Midazolam) trial received a sedative study drug completed at least one assessment. Interventions: Sedative interruption and/or titration...
Clinical practice guidelines are published and promoted, often by professional societies, because they provide a current transparently analyzed review of relevant research written with the aim to guide clinical practice. The 2018 Pain, Agitation/sedation, Delirium, Immobility (rehabilitation/mobilization), Sleep (disruption) (PADIS) (1) first 1) builds on this mission updating 2013 PAD (2); 2) adding two inextricably related care topics (immobility sleep); 3) including patients as...
Many patients with severe stroke have impaired airway protective reflexes, resulting in prolonged invasive mechanical ventilation.To test whether early vs standard tracheostomy improved functional outcome among receiving ventilation.In this randomized clinical trial, 382 acute ischemic or hemorrhagic ventilation were randomly assigned (1:1) to (≤5 days of intubation) ongoing ventilator weaning if needed from day 10. Patients between July 28, 2015, and January 24, 2020, at 26 US German...
Objective To describe the level of sedation for a cohort mechanically ventilated adult intensive care unit (ICU) patients using validated subjective and objective tools. Design Prospective convenience sample. Setting Multidisciplinary 34-bed ICU at Maine Medical Center, 599-bed nonuniversity, academic medical center. Patients Sixty-three were monitored during 64 episodes ventilatory support. Measurements Main Results prospectively evaluated by one trained investigator revised...
To evaluate the safety and efficacy of continuous infusion haloperidol in treating agitated critically ill adult patients.Case series patients treated with followed to hospital discharge, during a 6-month period.A 34-bed multidisciplinary intensive care unit (ICU) 598-bed nonuniversity, tertiary teaching hospital.Consecutive sample eight requiring mechanical ventilation who had severe agitation which was refractory intermittent bolus treatment benzodiazepines, narcotics,...
To investigate the association between adverse events recorded during critical care and mortality in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia.Prospective, observational, registry-based study.Twenty-two hospitals Europe United States.Between October 2004 2008, 765 were included.None.Arrhythmias (7%-14%), pneumonia (48%), metabolic electrolyte disorders (5%-37%), seizures (24%) common period hypothermia, whereas sepsis (4%) bleeding (6%) less frequent....
Abstract. Objective: To assess adrenocortical function following intravenous etomidate use in emergency department (ED) patients requiring intubation. Methods: This was a prospective, randomized, controlled trial of consecutive presenting to the ED Patients were randomized receive single bolus induction dose either 0.05‐0.1 mg/kg midazolam (control group) or 0.3 (etomidate during standardized rapid‐sequence intubation (RSI) with succinylcholine. The primary outcome variable at 4, 12, and 24...
Objectives: A recent randomized trial of mechanical ventilation in acute lung injury (ALI)/adult respiratory distress syndrome (ARDS) demonstrated a 22% relative reduction mortality rate using 6 mL/kg predicted body weight tidal volume vs. 12 volume. We determined whether publication these findings changed clinical practice. Design: Retrospective cohort, months before (Pre) and after (Post) supporting the use strategy. Setting: Three tertiary care hospitals northern New England. Patients:...
To revise the "Clinical Practice Guidelines for Sustained Use of Sedatives and Analgesics in Critically Ill Adult" published Critical Care Medicine 2002. The American College assembled a 20-person, multidisciplinary, multi-institutional task force with expertise guideline development, pain, agitation sedation, delirium management, associated outcomes adult critically ill patients. force, divided into four subcommittees, collaborated over six years person, via teleconferences, electronic...
Abstract Background While nurses play a key role in identifying delirium, several authors have noted variability their ability to recognize delirium. We sought measure the impact of simple educational intervention on intensive care unit (ICU) clinically identify delirium and use standardized scale correctly. Methods Fifty ICU from two different hospitals (university medical community teaching) evaluated an patient for pain, level sedation presence before after intervention. The same was...
To evaluate the outcomes of cardiac arrest survivors with myoclonus receiving modern postresuscitation care.Retrospective review registry data.Cardiac centers in Europe and United States from 2002 to 2012.Two thousand five hundred thirty-two 18 years or older enrolled International Cardiac Arrest Registry.None.Eighty-eight percent patients underwent therapeutic hypothermia 471 (18%) exhibited myoclonus. Patients had longer time professional cardiopulmonary resuscitation (8.6 vs 7.0 min; p <...
To compare the intensive care unit costs and determine factors influencing these in mechanically ventilated patients randomized to dexmedetomidine or midazolam by continuous infusion.Cost minimization analysis of a double-blind, multicenter clinical trial randomizing 2:1 receive from institutional perspective.Sixty-eight units United States, Australia, New Zealand, Brazil, Argentina.A total 366 intubated anticipated require sedation for >24 hrs.Intensive resource use was compared within two...
Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate association outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). performed a retrospective analysis prospectively collected data from International Cardiac Arrest Registry. Adult patients non-traumatic MIH were included. Good neurological was defined as cerebral...