Therapeutic options for agitation in the intensive care unit

Aubanel, Sarah; Bruiset, Florian; Chapuis, Claire; Chanques, Gérald; Payen, Jean François

doi:10.1016/j.accpm.2020.01.009

Cited by 19 publications

(10 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This trial was fully approved by the Ethics Committee of Dalian Municipal Central Hospital (20201-094-01). The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2200062799) 1 with the listed primary and secondary endpoints. The study was conducted in accordance with the clinical trial protocol (and any revisions), the Declaration of Helsinki (current revision), the Guidelines for analgesia and sedation treatment in intensive care unit of Chinese adults, and Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (2,8).…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of ciprofol for agitation and delirium in the ICU: A multicenter, single-blind, 3-arm parallel randomized controlled trial study protocol

Liu

Zhou

et al. 2023

Front. Med.

View full text Add to dashboard Cite

BackgroundAgitation is very common in the intensive care unit (ICU). The causes include pain, delirium, underlying disease, withdrawal syndrome, and some drug treatments. The practical goal of ICU treatment is to find an appropriate sedation regimen to reduce pain, restlessness, and delirium. Previous trials have examined the use of dexmedetomidine, but no trials have evaluated the efficacy and safety of ciprofol, a new sedative drug.MethodsThis study was a multicenter, single-blind, 3-arm parallel randomized controlled trial. ICU patients aged ≥ 18 years with agitation and delirium who met the eligibility criteria were included. The main outcome was the proportion of patients who needed additional study medication or midazolam due to agitation within 4 h after the first intravenous injection of the study medication. The secondary outcomes included the pass rate as indicated by a Richmond Agitation-Sedation Scale (RASS) score < +1, the effectiveness rate of improving delirium symptoms, the number of recurrences of agitation within 24 h, the incidence of rescue treatment, the dose and cost of analgesic and sedative drugs, the length and cost of ICU stay, and the 30-day survival period. The safety evaluation included the incidence of adverse events (hypotension, bradycardia, hypoxia, etc.) and the rate of endotracheal intubation. The subjects were randomly assigned to receive ciprofol, dexmedetomidine, or normal saline at a ratio of 1:1:1. The rates of additional drug administration within 4 h after the first injection of the study drug in the three groups were 40, 50, and 90%, respectively. A total sample size of 81 subjects was required to reach 90% power and an α of 0.05. Considering a 20% loss rate, 102 patients were enrolled and randomly assigned to the three groups in equal proportions.Ethics and communicationThis trial was approved by the Ethics Committee of Dalian Municipal Central Hospital. The communication plan includes presentations at scientific conferences, scientific publications, and presentations to the public through non-professional media.Clinical trial registrationwww.ClinicalTrials.gov, identifier ChiCTR220006 2799.

show abstract

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of ciprofol for agitation and delirium in the ICU: A multicenter, single-blind, 3-arm parallel randomized controlled trial study protocol

Liu

Zhou

et al. 2023

Front. Med.

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Agitation is a state of anxiety or nervous excitement that is accompanied by sudden and intense movements and unpredictable behaviors due to discomfort [6,7]. Agitation occurs in critically ill patients frequently with varying degrees accompanied with severe and persistent tremors, bed disorganization, and removal of the endotracheal tube and IV lines [4,6,8]. Agitated ICU patients face problems such as prolonged stay in intensive care units, removal of arterial and venous catheters, increased oxygen consumption, failure to participate in therapeutic interventions, injury to staff and patient, excessive use of sedatives, high costs, complications, and mortality [4,6,8].…”

Section: Introductionmentioning

confidence: 99%

“…In general, there are two pharmacological and nonpharmacological treatments for anxiety and agitation [6]. Pharmacological treatment often includes side effects of drops in blood pressure, impaired vital functions such as respiration and heart rate, drowsiness, nausea and vomiting, and allergic reactions and shock; numerous physical and psychological complications; and drug dependence and imposes high costs on the healthcare system [9].…”

Section: Introductionmentioning

confidence: 99%

“…Apparently, patients admitted to ICUs experience varying degrees of anxiety and agitation. Therefore, concerning the importance and problems caused by anxiety and agitation in conscious patients admitted to intensive care units, it is necessary to use appropriate strategies and control these symptoms [3,4,6,8,13]. Since nurses have the most contact with patients, they must use different nonpharmacological interventions to control the anxiety and agitation of conscious patients admitted to the ICUs because such interventions are easy to access and inexpensive with lower side effects compared with pharmacological ones [10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Lavender and Citrus aurantium on Anxiety and Agitation of the Conscious Patients in Intensive Care Units: A Parallel Randomized Placebo-Controlled Trial

Karimzadeh

Forouzi

Rahiminezhad

et al. 2021

BioMed Research International

View full text Add to dashboard Cite

Background. Conscious patients admitted to intensive care units (ICU) suffer from anxiety and agitation for various reasons, which can affect their recovery processes. Aims. To compare the effects of lavender and Citrus aurantium essential oils on anxiety and agitation of conscious patients admitted to ICUs. Design. A randomized parallel placebo-controlled trial. Methods. One hundred and fifty conscious patients admitted to ICUs were selected by convenience sampling and were randomly divided into three groups, groups of lavender aromatherapy and Citrus aurantium aromatherapy, in addition to the routine care and inhalation of five drops of lavender or Citrus aurantium essential oils for 30 minutes. The placebo group, in addition to routine care, was provided with 5 drops of normal saline for 30 minutes. Anxiety was assessed with the state subscale of State-Trait Anxiety Inventory, and agitation was examined with Richmond Agitation-Sedation Scale before, immediately, one hour, and three hours after the intervention. Results. All three groups suffered from relatively severe state anxiety before the intervention. The level of anxiety in the lavender and Citrus aurantium groups was significantly lower than that of the placebo group immediately and three hours after the intervention ( P < 0.05 ). No significant difference was observed between the two groups of lavender and Citrus aurantium. The majority of the samples in all three groups were agitated before the intervention, but agitation of all three groups decreased after the intervention. Restless/agitation reduced significantly in all three groups. Although restless/agitation of the lavender and Citrus aurantium groups reduced more than that of the placebo, no significant difference was found between the three groups. Conclusion. The results of the present study showed the positive effects of lavender aromatherapy and Citrus aurantium aromatherapy on reducing the anxiety of patients admitted to ICUs. Relevance to Clinical Practice. Aromatherapy can be used as an effective and safe intervention to reduce anxiety in ICUs.

show abstract