Introduction: The use of sedation in intensive care units (ICUs) is necessary and ubiquitous. The impact of sedation strategy on outcome, particularly when delivered early after initiation of mechanical ventilation, is unknown. Evidence is increasing that volatile anaesthetic agents could be associated with better outcome. Their use in delirium prevention is unknown.
Methods And Analysis: This study is an investigator-initiated, prospective, multicentre, two-arm, randomised, control, open-trial comparing inhaled sedation strategy versus intravenous sedation strategy in mechanically ventilated patients in ICU. Two hundred and fifty patients will be randomly assigned to the intravenous sedation group or inhaled sedation group, with a 1:1 ratio in two groups according to the sedation strategy. The primary outcome is the occurrence of delirium assessed using two times a day confusion assessment method for the ICU (CAM-ICU). Secondary outcomes include cognitive and functional outcomes at 3 and 12 months.
Ethics And Dissemination: The study has been approved by the Regional Ethics Committee (CPP Ouest) and national authorities (ANSM). The results will be submitted for publication in peer-reviewed journals.
Trial Registration Number: NCT04341350.
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http://dx.doi.org/10.1136/bmjopen-2020-042284 | DOI Listing |
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Background: Female sterilization, a safe, permanent method of contraception that blocks the fallopian tubes, has been in use since the 19th century. The procedure necessitates informed consent, a critical step that has been marred by reports of forced sterilization since World War II. These incidents often stem from inadequate consent processes where ethical principles are overlooked or deliberately flouted.
View Article and Find Full Text PDFCrit Care
January 2025
Trauma Critical Care Unit, Montpellier University Hospital, 34295 Cedex 5, Montpellier, France.
Background: External lumbar drainage (ELD) of cerebrospinal fluid may help control intracranial pressure following a traumatic brain injury. We aimed to assess the efficacy and safety of ELD in post-traumatic intracranial hypertension (IH).
Methods: This retrospective monocentric cohort study was conducted in the trauma critical care unit of the regional Level-I trauma centre between January 2012 and December 2022.
Ann Burns Fire Disasters
December 2024
Burn Intensive Care Unit, Poison Control Center, Cardarelli Hospital, Naples, Italy.
The use of new oxygen supports associated to non-invasive respiratory strategies is well-established in clinical practice, especially after its extensive application in the management of Covid-19 respiratory failure. The use of high flow nasal cannula (HFNC) in patients undergoing procedural sedation and analgesia (PSA) is dramatically increasing. Enzymatic debridement in critical burn patients is a painful treatment that requires an optimal burn pain control protocol as well as a deep sedation for the entire duration of the procedure.
View Article and Find Full Text PDFFront Psychiatry
December 2024
LVR-University Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Background: The lockdown measures during the SARS-CoV-2 pandemic could have influenced drug consumption patterns of persons with drug use disorder, especially due to a reduced availability of drugs, an increased consumption of sedating substances as a coping strategy, or a shift to novel psychotropic substances (NPS) associated with an increased drug buying in the internet. In this study, the consumption patterns of people mainly with opioid use disorder entering inpatient drug detoxification treatment were investigated in the same hospitals with the same methods before and during the pandemic.
Methods: At admission, patients were interviewed regarding their consumption patterns using the EuropASI questionnaire.
World J Gastrointest Endosc
December 2024
Department of Gastroenterology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China.
In this article we comment on the article by Walayat . Outpatient endoscopy has become vital in modern healthcare, providing efficient diagnostic and therapeutic interventions with minimal patient disruption. This study highlighted the key developments in sedation management, focusing on risk stratification and procedural settings to enhance safety.
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