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April 12, 2016

The Evolving Approach to Brain Dysfunction in Critically Ill Patients

Author Affiliations
  • 1Division of Allergy and Pulmonary Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
  • 2Veterans Affairs Tennessee Valley Health Care System, Nashville, Tennessee
  • 3VA Geriatric Research, Education, and Clinical Center, Nashville, Tennessee
  • 4Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;315(14):1455-1456. doi:10.1001/jama.2016.2708

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.