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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)
INTRODUCTION While propofol is associated with an infusion syndrome (PRIS) that may cause death, the incidence of PRIS is unknown. Determining the incidence of PRIS and the frequency of PRIS-related clinical manifestations are key steps prior to the completion of any controlled studies investigating PRIS. This prospective, multicenter study sought to(More)
OBJECTIVE To establish the validity and reliability of a new sedation scale, the Motor Activity Assessment Scale (MAAS). DESIGN Prospective, psychometric evaluation. SETTING Sixteen-bed surgical intensive care unit (SICU) of a 937-bed tertiary care, university-affiliated teaching hospital. PATIENTS Twenty-five randomly selected, adult, mechanically(More)
OBJECTIVE To compare the efficacy and safety of scheduled quetiapine to placebo for the treatment of delirium in critically ill patients requiring as-needed haloperidol. DESIGN Prospective, randomized, double-blind, placebo-controlled study. SETTING Three academic medical centers. PATIENTS Thirty-six adult intensive care unit patients with delirium(More)
CONTEXT Protocolized sedation and daily sedation interruption are 2 strategies to minimize sedation and reduce the duration of mechanical ventilation and intensive care unit (ICU) stay. We hypothesized that combining these strategies would augment the benefits. OBJECTIVE To compare protocolized sedation with protocolized sedation plus daily sedation(More)
The ideal sedative or analgesic agent should have a rapid onset of activity, a rapid recovery after drug discontinuation, a predictable dose response, a lack of drug accumulation,and no toxicity. Unfortunately, none of the earlier analgesics, the benzodiazepines,or propofol share all of these characteristics. Patients who are critically ill experience(More)
HYPOTHESIS Risk factors for Candida infection in surgical intensive care units (SICUs) change over time. Risk factor progression may influence Candida colonization and infection. DESIGN Multicenter cohort survey. SETTING Three urban teaching institutions. PATIENTS A total of 301 consecutively admitted patients in SICUs for 5 or more days. MAIN(More)
A lot of people believe that distinct objects can occupy precisely the same place for the entire time during which they exist. Such people have to provide an answer to the 'grounding problem'—they have to explain how such things, alike in so many ways, nonetheless manage to fall under different sortals, or have different modal properties. I argue in detail(More)
The Tasman International Geospace Environment Radar (TIGER), which is part of the global SuperDARN network, is a dual HF radar system with overlapping footprints designed to map ionospheric motions by detecting ionospheric scatter. The stereo SuperDARN radar concept is an interesting new innovation that effectively enables two radars to operate from the one(More)
BACKGROUND Use of dexmedetomidine or propofol rather than a benzodiazepine sedation strategy may improve ICU outcomes. We reviewed randomized trials comparing a benzodiazepine and nonbenzodiazepine regimen in mechanically ventilated adult ICU patients to determine if differences exist between these sedation strategies with respect to ICU length of stay,(More)