ICUSYNDROME分析.pptVIP

Managing ICU Delirium Look for it Communication between nursing and MDs Identify and treat correctable risk factors Optimize non-pharmacologic interventions Goal-oriented sedation with daily wake-ups Pharmacologic intervention Daily Wake-Ups Kress et al, NEJM 2000: 128 vented MICU patients randomized to daily awakening vs usual care AND midazolam vs propofol (all patients received morphine) Infusions off until following commands or agitated Shorter time on vent (4.9 vs 7.3 days) Shorter time in ICU (6.4 vs 9.9 days) Fewer diagnostic tests for mental status No difference in complications or PTS