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Critically ill patients present unique management challenges; however, some clinical problems in the intensive care unit (ICU) setting are remarkably consistent and ubiquitous. For instance, virtually every intensivist is likely to encounter the recurrent problem examined in the Dexmedetomidine to Lessen ICU Agitation (DahLIA) trial reported by Reade and colleagues1 in this issue of JAMA, but is equally likely not to have a data-driven answer to address it. This common scenario in the ICU involves caring for a patient whose critical illness has resolved, but who has delirium with severe agitation that necessitates some form of continued restraint (physical, chemical, or both) for the safety of the patient and staff and prolongs mechanical ventilation.
Ely EW, Pandharipande PP. The Evolving Approach to Brain Dysfunction in Critically Ill Patients. JAMA. 2016;315(14):1455-1456. doi:10.1001/jama.2016.2708