Scheduled intravenous opioids

McKenzie, Cathrine; Skrobik, Yoanna; Devlin, John W.

doi:10.1007/s00134-023-07254-x

Intensive Care Med

2023

DOI: 10.1007/s00134-023-07254-x

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Scheduled intravenous opioids

Cathrine McKenzie,

Yoanna Skrobik,

John W. Devlin

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2024

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Cited by 2 publications

References 17 publications

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Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future

Devlin

2024

Semin Neurol

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Despite the use of multidomain prevention strategies, delirium still frequently occurs in hospitalized adults. With delirium often associated with undesirable symptoms and deleterious outcomes, including cognitive decline, treatment is important. Risk-factor reduction and the protocolized use of multidomain, nonpharmacologic bundles remain the mainstay of delirium treatment. There is a current lack of strong evidence to suggest any pharmacologic intervention to treat delirium will help resolve it faster, reduce its symptoms (other than agitation), facilitate hospital throughput, or improve post-hospital outcomes including long-term cognitive function. With the exception of dexmedetomidine as a treatment of severe delirium-associated agitation in the ICU, current practice guidelines do not recommend the routine use of any pharmacologic intervention to treat delirium in any hospital population. Future research should focus on identifying and evaluating new pharmacologic delirium treatment interventions and addressing key challenges and gaps surrounding delirium treatment research.

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Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future

Devlin

2024

Semin Neurol

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Management of pain and sedation in the intensive care unit

Boncyk,

Rolfsen,

Richards

et al. 2024

BMJ

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Advances in our approach to treating pain and sedation when caring for patients in the intensive care unit (ICU) have been propelled by decades of robust trial data, knowledge gained from patient experiences, and our evolving understanding of how pain and sedation strategies affect patient survival and long term outcomes. These data contribute to current practice guidelines prioritizing analgesia-first sedation strategies (analgosedation) that target light sedation when possible, use of short acting sedatives, and avoidance of benzodiazepines. Together, these strategies allow the patient to be more awake and able to participate in early mobilization and family interactions. The covid-19 pandemic introduced unique challenges in the ICU that affected delivery of best practices and patient outcomes. Compliance with best practices has not returned to pre-covid levels. After emerging from the pandemic and refocusing our attention on optimal pain and sedation management in the ICU, it is imperative to revisit the data that contributed to our current recommendations, review the importance of best practices on patient outcomes, and consider new strategies when advancing patient care.

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Scheduled intravenous opioids

Cited by 2 publications

References 17 publications

Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future

Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future

Management of pain and sedation in the intensive care unit

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