The complex interplay between delirium, sepsis and sedation.
Critically ill patients requiring mechanical ventilation frequently suffer from intensive care unit delirium, a syndrome associated with numerous poor measured outcomes. The relationship between delirium, sepsis, and sedation is complex. A discussion of the recent study ('Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS [maximizing efficacy of targeted sedation and reducing neurological dysfunction] randomized controlled trial') by Pandharipande and colleagues is presented in this commentary.
Kress
John P
JP
Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, 5841 South Maryland, MC 6026, Chicago, IL 60637, USA. jkress@medicine.bsd.uchicago.edu
D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D016638:Critical Illness; D003693:Delirium / Q000150:complications* / Q000401:mortality; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007362:Intensive Care Units; D008140:Lorazepam / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D018805:Sepsis / Q000150:complications / Q000503:physiopathology*
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008140:Lorazepam