Implementation of a Dexmedetomidine Stewardship Program at a Tertiary Academic Medical Center

Annals of Pharmacotherapy

Volumn 47, Issue 11, 2013, Pages 1400-1405

  Blum, Rachel M ^a   Stevens, Craig A ^a   Carter, Danielle M ^a   Hussey, Aaron P ^a   Marquis, Kathleen A ^a   Torbic, Heather ^a   Southard, Robert A ^b   Szumita, Paul M ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b NORTHWESTERN MEMORIAL HOSPITAL   (United States)

Author keywords

agitation; delirium; dexmedetomidine; intensive care unit; pain; sedation

Indexed keywords

DEXMEDETOMIDINE;

ADULT; ARTICLE; BURN; DESCRIPTIVE RESEARCH; DRUG UTILIZATION; EXTUBATION; HEALTH PROGRAM; HEART SURGERY; HUMAN; INJURY; INTENSIVE CARE UNIT; MAJOR CLINICAL STUDY; PHARMACIST; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROSPECTIVE STUDY; SEDATION;

AGITATION; DELIRIUM; DEXMEDETOMIDINE; INTENSIVE CARE UNIT; PAIN; SEDATION;

ACADEMIC MEDICAL CENTERS; ADULT; DEXMEDETOMIDINE; DRUG PRESCRIPTIONS; DRUG UTILIZATION REVIEW; GUIDELINE ADHERENCE; HUMANS; INTENSIVE CARE UNITS; PATIENT SATISFACTION; PHARMACISTS; PHARMACY SERVICE, HOSPITAL; PROFESSIONAL ROLE; PROSPECTIVE STUDIES; QUALITY ASSURANCE, HEALTH CARE; TERTIARY CARE CENTERS; UNITED STATES; YOUNG ADULT;

EID: 84889063546     PISSN: 10600280     EISSN: 15426270     Source Type: Journal    
DOI: 10.1177/1060028013504086     Document Type: Article

References (35)

1. Hospira. Precedex™ (dexmedetomidine hydrochloride) injection [prescribing information]. http://www.precedex.com/wp-content/uploads/2010/11/Precedex_PI.pdf. Accessed September 14, 2012.
2. Hoy SM,Keating GM.Dexmedetomidine: a review of its use for sedation in mechanically ventilated patients in an intensive care setting and for procedural sedation.Drugs. 2011;71:1481-1501.
3. Anger KE.Dexmedetomidine: a review of its use for the management of pain, agitation, and delirium in the intensive care unit.Curr Pharm Des. 2013;19:4003-13.
4. Pichot C,Ghignone M,Quintin L.Dexmedetomidine and clonidine: from second- to first-line sedative agents in the critical care setting?.J Intensive Care Med. 2012;27:219-237.
5. Szumita PM,Baroletti SA,Anger KE,Wechsler ME.Sedation and analgesia in the intensive care unit: evaluating the role of dexmedetomidine.Am J Health Syst Pharm. 2007;64:37-44.
6. Gerlach AT,Dasta JF.Dexmedetomidine: an updated review.Ann Pharmacother. 2007;41:245-252.
7. Wunsch H,Kahn JM,Kramer AA,et al.Dexmedetomidine in the care of critically ill patients from 2001 to 2007: an observational cohort study.Anesthesiology. 2010;113:386-394.
8. Dasta JF,Kane-Gill SL,Durtschi AJ.Comparing dexmedetomidine prescribing patterns and safety in the naturalistic setting versus published data.Ann Pharmacother. 2004;38:1130-1135.
9. Dellit TH,Owens RC,McGowan JE,et al.Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship.Clin Infect Dis. 2007;44:159-177.
10. Gross R,Morgan AS,Kinky DE,Weiner M,Gibson GA,Fishman NO.Impact of a hospital-based antimicrobial management program on clinical and economic outcomes.Clin Infect Dis. 2001;33:289-295.
11. Magedanz L,Silliprandi EM,dos Santos RP.Impact of the pharmacist on a multidisciplinary team in an antimicrobial stewardship program: a quasi-experimental study.Int J Clin Pharm. 2012;34:290-294.
12. Marshall J,Finn CA,Theodore AC.Impact of a clinical pharmacist-enforced intensive care unit sedation protocol on duration of mechanical ventilation and hospital stay.Crit Care Med. 2008;36:427-433.
13. Barr J,Fraser GL,Puntillo K,et al.Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit.Crit Care Med. 2013;41:278-280.
14. Barr J,Fraser GL,Puntillo K,et al.Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit: executive summary.Am J Health Syst Pharm. 2013;70:53-58.
15. Drew RH.Antimicrobial stewardship programs: how to start and steer a successful program.J Manag Care Pharm. 2009;15:S18-S23.
16. John JF,Fishman NO.Programmatic role of the infectious diseases physician in controlling antimicrobial costs in the hospital.Clin Infect Dis. 1997;24:471-485.
17. Riker RR,Shehabi Y,Bokesch PM,et al.Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial.JAMA. 2009;301:489-499.
18. Jakob SM,Ruokonen E,Grounds RM,et al.Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials.JAMA. 2012;307:1151-1160.
19. Sessler CN.Progress toward eliminating inadequately managed pain in the ICU through interdisciplinary care.Chest. 2009;135:894-896.
20. Sessler CN,Grap MJ,Ramsay MA.Evaluating and monitoring analgesia and sedation in the intensive care unit.Crit Care. 2008;12:S2.
21. Sessler CN,Pedram S.Protocolized and target-based sedation and analgesia in the ICU.Crit Care Clin. 2009;25:489-513.
22. Sessler CN,Pedram S.Protocolized and target-based sedation and analgesia in the ICU.Anesthesiol Clin. 2011;29:625-650.
23. Sessler CN,Varney K.Patient-focused sedation and analgesia in the ICU.Chest. 2008;133:552-565.
24. Schweickert WD,Pohlman MC,Pohlman AS,et al.Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial.Lancet. 2009;373:1874-1882.
25. Schweickert WD,Gehlbach BK,Pohlman AS,Hall JB,Kress JP.Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients.Crit Care Med. 2004;32:1272-1276.
26. Schweickert WD,Kress JP.Implementing early mobilization interventions in mechanically ventilated patients in the ICU.Chest. 2011;140:1612-1617.
27. Girard TD,Kress JP,Fuchs BD,et al.Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (awakening and breathing controlled trial): a randomised controlled trial.Lancet. 2008;371:126-134.
28. Brook AD,Ahrens TS,Schaiff R,et al.Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation.Crit Care Med. 1999;27:2609-2615.
29. Quenot JP,Ladoire S,Devoucoux F,et al.Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia.Crit Care Med. 2007;35:2031-2036.
30. Chanques G,Jaber S,Barbotte E,et al.Impact of systematic evaluation of pain and agitation in an intensive care unit.Crit Care Med. 2006;34:1691-1699.
31. Skrobik Y,Ahern S,Leblanc M,Marquis F,Awissi DK,Kavanagh BP.Protocolized intensive care unit management of analgesia, sedation, and delirium improves analgesia and subsyndromal delirium rates.Anesth Analg. 2010;111:451-463.
32. Strom T,Martinussen T,Toft P.A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial.Lancet. 2010;375:475-480.
33. Strom T,Johansen RR,Prahl JO,Toft P.Sedation and renal impairment in critically ill patients: a post hoc analysis of a randomized trial.Crit Care. 2011;15:R119.
34. Strom T,Stylsvig M,Toft P.Long-term psychological effects of a no-sedation protocol in critically ill patients.Crit Care. 2011;15:R293.
35. Pandharipande P,Shintani A,Peterson J,et al.Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients.Anesthesiology. 2006;104:21-26.