Management of pain, agitation, and delirium in critically ill patients

Weaning centre — siedmioletnie doświadczenia jednego ośrodka

“…Our findings are satisfactory as the median time between admission and transfer was only 25 days (IQR 17; 41 days). Moreover, it was demonstrated that a high index of successful mechanical ventilation weaning could be obtained with early and regular extubation attempts according to the pain -agitation -delirium (PAD) protocol [14]; when failed -with early institution of specialist treatment in weaning stations [15]. In patients receiving longer ventilation and sedation, the risk of respiratory, circulatory and infectious complications is higher, which translates into a poor prognosis [10,15].…”

Noninvasive ventilation for hypercapnic exacerbation of chronic obstructive pulmonary disease: factors related to noninvasive ventilation failure

“…Ozyilmaz et al 33 identified the following nonpatient related risk factors for NIV failure: 1) timing (ie, when NIV is performed); 2) the setting (ie, where NIV is performed) and choice of ventilator (dedicated NIV ventilators perform better than ICU ventilators, particularly in terms of leak compensation and patient-ventilator synchrony); and the factors used in the univariate analysis showed that SAPS II on admission, the presence of comorbidities, pH on admission and after 1 hour of NIV, and the PaO 2 /FiO 2 ratio on admission were independently associated with hospital mortality in the overall population (TABLE 3). DISCUSSION …”

“…In addition, much attention has been paid to the development of new interfaces to increase tolerance and patient comfort, since mask intolerance remains the major cause of NIV failure. 33 An oro-nasal mask is generally the most common, followed by a nasal mask, helmet, and mouthpiece. These interfaces have a number of advantages and disadvantages, and, in case of poor tolerance, it is reasonable to apply the so called rotating strategy.…”

“…These interfaces have a number of advantages and disadvantages, and, in case of poor tolerance, it is reasonable to apply the so called rotating strategy. 33 In this context, a skilled and experienced staff may treat more severe patients with better outcomes. 13,31 Moreover, an expert team may be more experiences in the management of pain, agitation, and sleep disturbances caused by prolonged duration of mechanical ventilation.…”

HPLC-MS/MS Based Time Course Analysis of Morphine and Morphine-6- Glucoronide in ICU Patients

“…It is also commonly used to treat post-operative pain in the intensive care unit (ICU) [1]. Morphine is metabolized by conjugation to morphine-3-glucoronide (M3G) and morphine-6-glucoronide (M6G) [2].…”