title: Diazepam as a component of goal-directed sedation in critically ill trauma patients.
abstract: OBJECTIVE
  Limited information addressing the safety and efficacy of diazepam in the intensive care unit, particularly in trauma patients, is available. The purpose of this study is to evaluate the safety and efficacy of diazepam when used in routine clinical practice as a component of a goal-directed sedation regimen in critically ill trauma patients.
  
  
  METHODS
  This is a prospective observational evaluation of adult trauma patients admitted to an intensive care unit with orders for as-needed midazolam or lorazepam followed by scheduled diazepam. Medication administration and Sedation-Agitation Scale scores were recorded.
  
  
  RESULTS
  Twenty-four patients were evaluated. The most common diazepam dosage was 10 mg every 6 hours, and individual doses ranged from 5 to 30 mg. Sedation-Agitation Scale scores were recorded a median of 20 times per day (interquartile range, 15-24), and the majority (68%) were in the target range. No diazepam-related adverse events were observed.
  
  
  CONCLUSIONS
  Based on this limited sample, the use of diazepam as a component of goal-directed therapy appears safe and effective in providing adequate sedation in critically ill trauma patients using an average dosage of 40 mg/d.
authors.affiliation: Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA. gail.gesin@carolinashealthcare.org
authors.forename: Gail
authors.initials: G
authors.lastname: Gesin
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Kane-Gill
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Dasta
authors.forename: Kara L
authors.initials: KL
authors.lastname: Birrer
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Kolnik
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cheatham
mesh_terms: D018806:APACHE; D000328:Adult; D016638:Critical Illness; D003975:Diazepam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007362:Intensive Care Units; D007902:Length of Stay; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D011446:Prospective Studies; D012121:Respiration, Artificial; D014947:Wounds and Injuries / Q000188:drug therapy* / Q000628:therapy
chemical_list: D006993:Hypnotics and Sedatives; D008140:Lorazepam; D003975:Diazepam; D008874:Midazolam