Journal of intensive care medicine
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J Intensive Care Med · Aug 2016
Comparative StudyComparison of Dexmedetomidine Versus Propofol on Hospital Costs and Length of Stay.
The objective of this evaluation was to compare total hospital costs and length of stay of critically ill patients who received dexmedetomidine versus propofol for sedation in the intensive care unit (ICU). ⋯ In this academic medical center, dexmedetomidine use was associated with higher costs when compared to propofol for sedation in the ICU. Also, use of dexmedetomidine was associated with increased lengths of ICU and hospital stay. Future prospective trials are needed to confirm these findings.
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J Intensive Care Med · Aug 2016
ReviewEmerging Role of Melatonin and Melatonin Receptor Agonists in Sleep and Delirium in Intensive Care Unit Patients.
Delirium, an acute state of mental confusion, can lead to many adverse sequelae in intensive care unit (ICU) patients. Although the etiology of ICU delirium is often multifactorial, and at times not fully understood, sleep deprivation is considered to be a major contributing factor to its development. ⋯ Although few studies evaluating the impact of melatonergic agents on sleep and delirium in the ICU have been completed, some data suggest their potential positive effects on sleep and delirium. However, large-scale randomized controlled trials are warranted to determine the optimal role of melatonergic agents in the prevention of ICU delirium.
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J Intensive Care Med · Aug 2016
Does the Subjective Global Assessment Predict Outcome in Critically Ill Medical Patients?
The Subjective Global Assessment (SGA) is a validated nutrition assessment tool that is not commonly used to evaluate the nutritional status of patients admitted to the intensive care unit (ICU). ⋯ Malnutrition on admission is common in critically ill medical patients. Malnutrition, as assessed by SGA at admission to ICU, is associated with increased mortality and thus can serve as a valuable prognostic tool in the assessment of critically ill patients. Given that that the SGA is a simple bedside assessment, it should be considered for routine use in assessing critically ill patients.
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J Intensive Care Med · Aug 2016
Early Trophic Enteral Nutrition Is Associated With Improved Outcomes in Mechanically Ventilated Patients With Septic Shock: A Retrospective Review.
Current guidelines provide weak recommendations for starting enteral nutrition (EN) in patients with septic shock (on vasopressor support). Outcomes of patients receiving EN in septic shock on vasopressor support have not been well studied. We hypothesize that early trophic EN in mechanically ventilated patients with septic shock is associated with improved outcomes. ⋯ In patients with septic shock, those receiving <600 kcal/d EN within 48 hours had lower DOMV and LOS when compared to those who did not receive EN or those who received ≥600 kcal/d. These observations provide strong justification for prospective evaluation of the effect of early trophic EN in patients with septic shock.