Sedation during noninvasive mechanical ventilation with dexmedetomidine or midazolam: A randomized, double-blind, prospective study

Şenoğlu, Nimet; Öksüz, Hafize; Doğan, Zafer; Yıldız, Hüseyin Bekir; Demirkıran, Hilmi; Ekerbiçer, Hasan Çetin

doi:10.1016/j.curtheres.2010.06.003

Cited by 67 publications

(57 citation statements)

References 25 publications

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“…Similar findings were referred to in a metaanalysis by Lynn and others [39] analysing the safety and efficiency of dexmedetomidine with post-operative cardio-surgical patients. Numerous studies comparing dexmedetomidine to propofol [40,41], midazolam [40,42,43], and morphine [44] confirmed that dexmedetomidine reduces the risk of delirium, agitation and/or confusion in critical ICU patients. This medicine is not yet registered in Serbia.…”

Section: Discussionmentioning

confidence: 99%

The importance of early recognition and timely treatment of delirium in intensive care units

Stašević-Karličić¹,

Stasevic²,

Djordjević³

et al. 2016

Praxis Med

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Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days) and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia). The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A -Delirium as a sign of system infection, B -Therapy -Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C -An inconspicuous onset of delirium is overlooked, D -Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F -Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H -The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30-40% of cases (50). An etiological treatment would help avoid complicating delirium's clinical picture and would very much prevent poor outcomes, such as institutionalisation, cognitive damage and delirious patients' high mortality rate.

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Section: Discussionmentioning

confidence: 99%

The importance of early recognition and timely treatment of delirium in intensive care units

Stašević-Karličić¹,

Stasevic²,

Djordjević³

et al. 2016

Praxis Med

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“…Taken together, the results of these studies are encouraging [7][8][9][10][11][12][13]. Overall, the use of sedation during NIV appears feasible and safe.…”

mentioning

confidence: 96%

“…In addition to the present trial [5], several observational studies [7][8][9][10][11] and three randomized trials comparing midazolam and dexmedetomidine or placebo [12][13][14] have assessed the potential use of sedative and/or analgesic drugs to reduce discomfort and risk of NIV failure. The main characteristics and results of these studies are Table 1.…”

mentioning

confidence: 99%

“…The first randomized controlled trial compared 24-h infusions of dexmedetomidine and midazolam in 40 uncooperative patients receiving NIV for ARF due to acute exacerbations of chronic obstructive pulmonary disease [12]. Though no patient experienced NIV failure during the study period, compared to midazolam, dexmedetomidine required fewer dosing adjustments to maintain adequate sedation (p \ 0.01).…”

mentioning

confidence: 99%

“…Overall, the use of sedation during NIV appears feasible and safe. The ''curative'' use of sedation-analgesia, i.e., applied for treating discomfort leading to NIV intolerance, seems to be able to avoid intubation in 55-70 % of cases [8][9][10][11][12][13], while ensuring the desired level of awake sedation. By contrast, the ''preventive'' administration of sedation-analgesia, i.e., at initiation of NIV to prevent discomfort leading to intolerance, has so far not shown encouraging results [14].…”

mentioning

confidence: 99%

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