Richard R . Riker

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Judith Jacobi, PharmD, FCCM, BCPS; Gilles L. Fraser, PharmD, FCCM; Douglas B. Coursin, MD; Richard R. Riker, MD; Dorrie Fontaine, RN, DNSc, FAAN; Eric T. Wittbrodt, PharmD; Donald B. Chalfin, MD, MS, FCCM; Michael F. Masica, MD, MPH; H. Scott Bjerke, MD; William M. Coplin, MD; David W. Crippen, MD, FCCM; Barry D. Fuchs, MD; Ruth M. Kelleher, RN; Paul E.(More)
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)
CONTEXT Gamma-aminobutyric acid receptor agonist medications are the most commonly used sedatives for intensive care unit (ICU) patients, yet preliminary evidence indicates that the alpha(2) agonist dexmedetomidine may have distinct advantages. OBJECTIVE To compare the efficacy and safety of prolonged sedation with dexmedetomidine vs midazolam for(More)
OBJECTIVE Subjective scales to assess agitation and sedation in adult intensive care unit (ICU) patients have rarely been tested for validity or reliability. We revised and prospectively tested the Sedation-Agitation Scale (SAS) for interrater reliability and compared it with the Ramsay scale and the Harris scale to test construct validity. DESIGN A(More)
OBJECTIVE To describe the level of sedation for a cohort of mechanically ventilated adult intensive care unit (ICU) patients using validated subjective and objective tools. DESIGN Prospective convenience sample. SETTING Multidisciplinary 34-bed ICU at Maine Medical Center, a 599-bed nonuniversity, academic medical center. PATIENTS Sixty-three adult(More)
To evaluate the bispectral index (BIS) and suppression ratio (SR) as very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest. Demographic data, BIS1, and SR1 were recorded from 97 patients after the first dose of neuromuscular blockade, with outcomes blinded, and compared to the discharge Cerebral Performance(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)
OBJECTIVE To assess adrenocortical function following intravenous etomidate use in emergency department (ED) patients requiring intubation. METHODS This was a prospective, randomized, controlled trial of consecutive patients presenting to the ED requiring intubation. Patients were randomized to receive a single bolus induction dose of either 0.05-0.1(More)
Objective: To validate the Sedation-Agitation Scale (SAS) with the Visual Analog Scale (VAS) and Bispectral Index (BIS) in adult ICU patients after cardiac surgery. Design: Prospective study comparing blinded evaluations of the SAS, VAS and BIS. Setting: Forty-two-bed multidisciplinary ICU. Patients and participants: Convenience sample of 39 adults after(More)
BACKGROUND Nationwide benchmarks representing current critical care practice for the range of ICUs are lacking. This information may highlight opportunities for care improvement and allows comparison of ICU practice data. METHODS Data representing 243,553 adult admissions from 271 ICUs and 188 US nonfederal hospitals during 2008 were analyzed using the(More)