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M aintaining an optimal level of comfort and safety for critically ill patients is a universal goal for critical care practitioners. The American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine's (SCCM's) practice parameters for the optimal use of sedatives and analgesics was published in 1995 and recommended a tiered(More)
Contemporary intensive care unit (ICU) medicine has complicated the issue of what constitutes death in a life support environment. Not only is the distinction between sapient life and prolongation of vital signs blurred but the concept of death itself has been made more complex. The demand for organs to facilitate transplantation promotes a strong incentive(More)
Aside from being hard for physicians and staff to cope with, ICU agitation syndromes result in deterioration of hemodynamics and must be handled effectively. The interaction between pain and delirium is examined, as well as hemodynamic and metabolic syndromes that cause agitation in the ICU setting. The various medications useful in the treatment of pain(More)
The disparity between the number of patients in need of organ transplantation and the number of available organs is steadily rising. We hypothesized that intensivist-led management of brain dead donors would increase the number of organs recovered for transplantation. We retrospectively analyzed data from all consented adult brain dead patients in the year(More)
Aggressive methods of decreasing oxygen consumption, such as therapeutic musculoskeletal paralysis, are used in patients with marginal oxygen delivery associated with cardiac and respiratory insufficiency. This is especially true of new mechanical ventilation methods designed to decrease tidal volume and peak airway pressures. Agitation and delirium(More)
A previously established model in awake rats of hemorrhagic shock (HS) with 25% spontaneous survival rate (without resuscitation) was used to evaluate the effects of 4 novel life-supporting first aid (LSFA) measures on survival time and rate. After shed blood volume (SBV) of 3.25 ml/100 g, withdrawn over 20 min, hemodynamic and respiratory responses were(More)
We previously determined that in awake, unmonitored Sprague-Dawley rats, bleeding of 2.5 ml/100 g over 20 min resulted in hemorrhagic shock (HS) with about a 75% survival rate over 24 h, and bleeding of 3.0 ml/100 g in about 25% survival to 24 h. In the present study, we monitored systolic and mean arterial pressure (MAP), central venous pressure (CVP),(More)