Most Read Articles
18 May 2020
Immobilization or disuse of the forearm leads to impairment in the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply, suggests a study. Disuse also lowers postprandial forearm amino acid uptake, but this is not exacerbated under high-fat conditions.
18 May 2020
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are more effective than basal insulin in the management of total (TC) and low-density lipoprotein cholesterol (LDL-C), reveals a recent study.
17 May 2020
Increased coffee consumption among regular drinkers is associated with higher estimated glomerular filtration rate and confers protection against the risk of chronic kidney disease stages G3–G5 and albuminuria, as shown in a study.
Jairia Dela Cruz, 16 May 2020
Excess weight, greater abdominal fat, inflammation and low physical performance can all contribute to insulin resistance in middle-age Singaporean women, and these variables explain why the condition is more common among women of Chinese than Malay and Indian ethnicities, a study has found.

Ventilator compliance drives transition from fentanyl to hydromorphone in critically ill patients

07 Apr 2020
The failure of communication between machines can cost critically ill patients supported by ventilators 10% of their survival chances.

The transition from continuous infusion fentanyl to continuous infusion hydromorphone in critically ill patients is motivated by ventilator compliance, better patient-specific pharmacokinetics, and reduction in sedative exposure, according to a study.

A single-centre, prospective, observational analysis was conducted to identify the rationales for the transition from continuous infusion fentanyl to continuous infusion hydromorphone in adult intensive care unit (ICU) patients who were transitioned from fentanyl to hydromorphone.

The primary endpoint was to determine the main reasons for the transition. Secondary endpoints included minor reasons for transition, transition dosing, changes in continuous sedative requirements and level of sedation.

Forty-six patients met the inclusion criteria. Ventilator compliance (28.3 percent) was the major reason for transition, followed by tachyphylaxis or better pain control (19.6 percent) and reduction in sedatives (13.0 percent). For minor reasons, the most common ones were reduction in sedative exposure (47.8 percent), opioid rotation (32.6 percent) and obesity (30.4 percent).

The transition was from a median fentanyl rate of 100 µg/h to 1 mg/h of hydromorphone. A reduction in the percentage of patients requiring the use of continuous sedatives occurred in the 24 hours following transition (p=0.005), but patients were more deeply sedated (p=0.02).

“The 2013 Society of Critical Care Medicine guidelines for the management of pain, agitation and delirium in adult ICU patients recommend intravenous opioids as first-line therapy to treat non-neuropathic pain,” the investigators said. “There is a paucity of literature describing possible benefits of utilizing specific opioids over others in ICU patients.”

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Most Read Articles
18 May 2020
Immobilization or disuse of the forearm leads to impairment in the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply, suggests a study. Disuse also lowers postprandial forearm amino acid uptake, but this is not exacerbated under high-fat conditions.
18 May 2020
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are more effective than basal insulin in the management of total (TC) and low-density lipoprotein cholesterol (LDL-C), reveals a recent study.
17 May 2020
Increased coffee consumption among regular drinkers is associated with higher estimated glomerular filtration rate and confers protection against the risk of chronic kidney disease stages G3–G5 and albuminuria, as shown in a study.
Jairia Dela Cruz, 16 May 2020
Excess weight, greater abdominal fat, inflammation and low physical performance can all contribute to insulin resistance in middle-age Singaporean women, and these variables explain why the condition is more common among women of Chinese than Malay and Indian ethnicities, a study has found.