Intensive Care - Drugs
AARC Clinical Practice Guideline (1999) Selection of device, administration of bronchodilator, and evaluation of response to therapy in mechanically ventilated patients. Respir Care, 44(1):105-113.
www.rcjournal.com/cpgs/pdf/01.99.105.pdf


Aljundi AHS, Mohammed SFK, Patel A et al (2016) Inotropic agents use in patients hospitalized with acute decompensated heart failure: a retrospective analysis from a 22-year registry in a Middle-Eastern Country (1991–2013). BMC Cardiovasc Disorders; 16:47. doi: 10.1186/s12872-016-0223-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759856/

Annane D (2016) What Is the evidence for harm of neuromuscular blockade and corticosteroid use in the intensive care unit? Semin Respir Crit Care Med; 37(1):51-6. doi: 10.1055/s-0035-1570355
• combined neuromuscular blocking agents and steroids can cause ICU-acquired weakness

Ari A, Harwood RJ, Sheard MM et al (2015) Pressurized metered-dose inhalers versus nebulizers in the treatment of mechanically ventilated subjects with artificial airways: an in vitro study. Respir Care; 60(11):1570-1574
rc.rcjournal.com/content/60/6/858.full
• delivery efficiency with inhaler is 3-fold greater than with nebulizer.
• aerosol drug delivery via trachy is greater than with ETT

Ari A (2015) Aerosol therapy in pulmonary critical care. Respir Care; 60(6):858-879. Discussion: 874-9. doi: 10.4187/respcare.03790
• nebuliser should be connected to the inspiratory limb of the circuit
• humidifier should not be removed, but for tracheostomied patients, inner cannula should be removed
• flow from the ventilator should be decreased during nebulisation
• many other practical tips

Balasubramaniam B (2003) Sexual hallucinations during and after sedation and anaesthesia.
• midazolam and propofol can cause sexual hallucinations

Ball L, Sutherasan Y, Caratto V C et al (2016) Effects of nebulizer position, gas flow, and CPAP on aerosol bronchodilator delivery: an in vitro study. Respir Care; 61(3):263-268
• optimum inhaled drug delivery is by T-piece with a cap at one extremity

Bassetti M, Luyt CE, Nicolau DP et al (2016) Characteristics of an ideal nebulized antibiotic for the treatment of pneumonia in the intubated patient. Ann Intensive Care; 6(1):35. doi: 10.1186/s13613-016-0140-x.
www.ncbi.nlm.nih.gov/pubmed/27090532

Bellgardt M, Bomberg H, Herzog-Niescery J et al (2016) Survival after long-term isoflurane sedation as opposed to intravenous sedation in critically ill surgical patients: retrospective analysis. Eur J Anaesthesiol; 33(1):6-13. doi: 10.1097/EJA.0000000000000252

Broomhead RH, Mallett SV (2013) Clinical aspects of coagulation and haemorrhage. Anaesth Int Care Med, 14(2):57-62

Bryan TL, van Diepen S, Bhutani M et al (2013) The effects of dobutamine and dopamine on intrapulmonary shunt and gas exchange in healthy humans. J Appl Physiol; 113(4):541-8. doi: 10.1152/japplphysiol.00404.2012
• dobutamine and dopamine can increase intrapulmonary shunt and neurological complications

Cedborg AI, Sundman E, Bodén K et al (2014) Pharyngeal function and breathing pattern during partial neuromuscular block in the elderly: effects on airway protection. Anesthesiology; 120(2):312-25. doi: 10.1097/ALN.0000000000000043

Charlton M, Thompson J (2017) Adverse drug reactions. Anaesth Int Care Med; 18(4):205–209

Ciurleo R, Bramanti P, Salvatore R et al (2013) Pharmacotherapy for disorders of consciousness: are ‘awakening’ drugs really a possibility? Drugs; 73(17):1849-1862
link.springer.com/article/10.1007/s40265-013-0138-8

De Bus L, Saerens L, Gadeyne B et al (2014) Development of antibiotic treatment algorithms based on local ecology and respiratory surveillance cultures to restrict the use of broad-spectrum antimicrobial drugs in the treatment of hospital-acquired pneumonia in the intensive care unit: a retrospective analysis. Crit Care; 18:R152. doi:10.1186/cc13990
• algorithm to reduce antibiotic use in the ICU.

Dhanani J, Fraser J, Chan H et al (2016) Fundamentals of aerosol therapy in critical care. Crit Care; 20:269
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1493-0

Johnston DA, Gilmore TW, Gosselin KP (2015) A comparison of metered-dose inhaled albuterol versus endotracheal liquid bolus albuterol for the treatment of bronchoconstriction. Respir Care; 60(5):627-635

Ebrahim H (2010) Noradrenaline versus dopamine in the treatment of circulatory shock. J Intens Care Soc, 11, 4, 272-4
journal.ics.ac.uk/pdf/1104272.pdf
• dopamine shows slightly more adverse effects than noradrenaline

Gajewski M, Weinhouse G (2016) The use of modafinil in the intensive care unit. J Intensive Care Med; 31(2):142-5. doi: 10.1177/0885066615571899

Gemma M, Pasin L, Oriani A et al (2016) Swallowing impairment during propofol target-controlled infusion. Anesth Analg; 122(1):48-54. doi: 10.1213/ANE.0000000000000796

Inverso G, Dodson TB, Gonzalez ML et al (2016) Complications of moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. J Oral Maxillofac Surg; 74(3):474-9. doi: 10.1016/j.joms.2015.10.009

Kaila M, Everingham K, Lapinlampi P et al (2015) A randomized controlled proof-of-concept trial of early sedation management using Responsiveness Index monitoring in mechanically ventilated critically ill patients. Crit Care; 19:333. doi: 10.1186/s13054

Kimmoun A, Levy B (2014) Angiotensin II: a new approach for refractory shock management? Crit Care, 18:694. doi:10.1186/s13054-014-0694-7
• vasodilators to help distributive shock

Kondili E, Alexopoulou C, Xirouchaki N et al (2012) Effects of propofol on sleep quality in mechanically ventilated critically ill patients: a physiological study. Intensive Care Med; 38(10):1640-6
• propofol suppresses REM sleep and impairs sleep

Li Y, He R, Chen S et al (2015) Effect of dexmedetomidine on early postoperative cognitive dysfunction and peri-operative inflammation in elderly patients undergoing laparoscopic cholecystectomy. Exp Ther Med; 10(5):1635-1642
• dexmedetomidine induces sedation and minimises postoperative delirium

Lin HL, Fink JB, Zhou Y (2009) Influence of moisture accumulation in inline spacer on delivery of aerosol using metered-dose inhaler during mechanical ventilation. Respir Care, 54, 10, 1336-41

McKenzie CA, McKinnon W, Naughton DP (2005) Differentiating midazolam over-sedation from neurological damage in the intensive care unit. Crit Care, 9, R32-R36
• method to differentiate over-sedation from neurological damage

Nordstrom K, Allen MH (2013) Alternative delivery systems for agents to treat acute agitation: progress to date. Drugs; 73(16):1783-1792

Ortega RMA, Jambrina CC, Vallhonrat LI et al (2014) Indications of dexmedetomidine in the current sedoanalgesia tendencies in critical patients. Med Intensiva; 38(1):41-48. doi: 10.1016/j.medin.2013.03.008

Pandharipande P, Banerjee A, McGrane S (2010) Liberation and animation for ventilated ICU patients: the ABCDE bundle for the back-end of critical care. Crit Care, 14, 3, 157. doi: 10.1186/cc8999
• the downside of sedation

Piriyapatsom A, Bittner A, Hines EA et al (2013) Sedation and paralysis. Respir Care, 58, 6, 1024-35

Porhomayon J, El-Solh AA, Adlparvar G et al (2016) Impact of sedation on cognitive function in mechanically ventilated patients. Lung; 194(1): 43-52. doi. 10.1007/s00408-015-9820-9
link.springer.com/journal/408/194/1/page/1#page-1

Porter R, McClure J (2013) Sedation and delirium in the intensive care unit. Anaesth Int Care Med, 14(1):22–26

Rafiei H, Abdar ME, Amiri M et al (2013) The study of harmful and beneficial drug interactions in intensive care. J Intens Care Soc; 14(2):155-8

Shehabi Y (2010) The effect of dexmedetomidine on agitation during weaning of mechanical ventilation in critically ill patients. Anaesth Int Care, 38, 82-90
xa.yimg.com/kq/groups/16749867/2013815741/name/The+effect+of+dexmedetomidine+on+agitation+during+weaning+of+mechanical+ventilation+in+critically+ill+patients-+Anesth+Intensiv
• Dexmedetomidine achieves rapid resolution of agitation

Smith MA, Hibino M, Falcione BA et al (2014) Immunosuppressive aspects of analgesics and sedatives used in mechanically ventilated patients: an underappreciated risk factor for the development of ventilator-associated pneumonia in critically ill patients. Ann Pharmacother; 48(1):77-85. doi: 10.1177/1060028013510698

Steingrub JS, Lagu T, Rothberg MB et al (2014) Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically ventilated patients with severe sepsis. Crit Care Med; 42(1):90-6. doi: 10.1097/CCM.0b013e31829eb7c9

Steingrub JS, Lagu T, Rothberg MB (2014) Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically ventilated patients with severe sepsis. Crit Care Med; 42(1):90-96. doi: 10.1097/CCM.0b013e31829eb7c9

Strøm T, Stylsvig M, Toft P (2011) Long-term psychological effects of a no-sedation protocol in critically ill patients. Crit Care, 15, 6, R293. doi: 10.1186/cc10586
www.ncbi.nlm.nih.gov/pmc/articles/PMC3388632/

Tanaka LM, Azevedo LC, Park M et al (2014) Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study. Crit Care; 18:R156 doi:10.1186/cc13995
• early deep sedation is associated with adverse outcomes

Tarvasmäki T, Lassus J, Varpula M et al (2016) Current real-life use of vasopressors and inotropes in cardiogenic shock - adrenaline use is associated with excess organ injury and mortality. Crit Care; 20(1):208. doi: 10.1186/s13054-016-1387-1.
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1387-1

Tomita S, Matsuura N, Ichinohe T (2013) The combined effects of midazolam and propofol sedation on muscle power. Anaesthesia; 68(5):478–83
• midazolam has sedative, anxiolytic and amnesic effects, propofol has sedative and antiemetic effects

Walsh BK, Rettig JS (2015) Implementation of an inhaled nitric oxide protocol: a paradox or the perfect pair? Respir Care; 60(5):760-761

Zhang H (2013) Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials. Crit Care, 17, R47 doi:10.1186/cc12566
• if sedation is required for delirium, dexmedetomidine is the preferred option

Zhang X, Wang R, Lu J et al (2016) Effects of different doses of dexmedetomidine on heart rate and blood pressure in intensive care unit patients. Exp Ther Med; 11(1):360-366


ETT = endotracheal tube