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OBJECTIVE To revise the "Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult" published in Critical Care Medicine in 2002. METHODS The American College of Critical Care Medicine assembled a 20-person, multidisciplinary, multi-institutional task force with expertise in guideline development, pain,(More)
BACKGROUND Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally. OBJECTIVE To validate the Critical-Care Pain Observation Tool. METHODS A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada,(More)
Bcl-2-family proteins are key regulators of the apoptotic response. Here, we demonstrate that the pro-survival Bcl-2 homolog Bfl-1/A1 is a direct transcriptional target of NF-kappaB. We show that bfl-1 gene expression is dependent on NF-kappaB activity and that it can substitute for NF-kappaB to suppress TNFalpha-induced apoptosis. bfl-1 promoter analysis(More)
BACKGROUND Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally. OBJECTIVES To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain(More)
PURPOSE The purpose of this study was to describe behavioral and physiologic indicators to a nociceptive procedure in conscious and unconscious mechanically ventilated adults and to examine their association with the patients' self-reports of pain. MATERIALS AND METHODS A total of 257 intensive care unit patients (144 conscious and 113 unconscious) from 4(More)
BACKGROUND The Critical-Care Pain Observation Tool (CPOT) is one of the few behavioural pain scales which have been developed and validated for the purpose of detecting pain in nonverbal critically ill adults. OBJECTIVES This study aimed to complete a pre and post evaluation of the implementation of the CPOT on pain assessment/management nursing practices(More)
The purpose of this randomized control trial was to verify the effectiveness of a brief group intervention that combines stress management psycho-education and physical activity (ie, independent variable) intervention in reducing fatigue and improving energy level, quality of life (mental and physical), fitness (VO 2submax), and emotional distress (ie,(More)
This pilot study aimed to explore the validity of the bispectral (BIS) index, the Critical-Care Pain Observation Tool (CPOT) score, and vital signs (mean arterial pressure, heart rate) during rest and painful procedures in sedated and mechanically ventilated ICU adults. A convenience sample of nine patients with various diagnoses participated in this(More)
The nuclear factor-kappaB (NF-kappaB) transcription factors have emerged as major regulators of programmed cell death (PCD) whether via apoptosis or necrosis. In this context, NF-kappaB's activity has important ramifications for normal tissue development, homoeostasis and the physiological functions of various cell systems including the immune, hepatic,(More)