In other words, you don't want to be delirious for long periods of time. But we do not know the mechanism of why that is so.
It literally seems to permanently alter brain function. The age old question is do you die with delirium or do you die because of it?
Interviewer: Sedation is important so that they can basically receive the care that they need. Interviewer: And do you have anything to add to that?
Nick Lonardo: Patients with renal failure, patients with liver dysfunction don't clear benzodiazepines rapidly, and those patients have a prolonged, almost an oversedation picture.
Interviewer: Sedation is commonly used in the intensive care unit to make patients that require mechanical ventilation more comfortable and less anxious.
What many don't realize is that sedation can have side effects that can endanger the patient's life. Richard Barton, Director of Surgical Critical Care at the University Hospital, and Nick Lonardo, Pharmacy Clinical Coordinator are investigating best practices for sedation use in the ICU. Barton, what is the problem that you're concerned with? Richard Barton: First, let me describe the patients that we have in the surgical and intensive care units. That means we have a machine that helps the patient breathe, but in order to do this these people have an endotracheal tube, which is stiffer and bigger than a soda straw, smaller than a garden hose. Richard Barton: Yes, well, imagine what it feels like when you stick your finger down your throat; it makes you throw up.
You can keep propofol on literally for days, and turn it off and your patient will awaken usually within an hour or so.
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And when we did the statistics, we were able to see a decrease in mortality associated with the propofol group, decreased time on the ventilator, decreased time in the ICU, and increased ventilator associated pneumonias associated with the benzodiazepines.
The most unexpected thing that we saw was a reduction in mortality, and that had not been shown before.