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intensive care unit delirium

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https://www.readbyqxmd.com/read/29236843/weakness-acquired-in-the-intensive-care-unit-incidence-risk-factors-and-their-association-with-inspiratory-weakness-observational-cohort-study
#1
Ladislao Pablo Diaz Ballve, Nahuel Dargains, José García Urrutia Inchaustegui, Antonella Bratos, Maria de Los Milagros Percaz, Cesar Bueno Ardariz, Sabrina Cagide, Carolina Balestrieri, Claudio Gamarra, Dario Paz, Eliana Rotela, Sebastian Muller, Fernando Bustos, Ricard Aranda Castro, Esteban Settembrino
OBJECTIVE: This paper sought to determine the accumulated incidence and analyze the risk factors associated with the development of weakness acquired in the intensive care unit and its relationship to inspiratory weakness. METHODS: We conducted a prospective cohort study at a single center, multipurpose medical-surgical intensive care unit. We included adult patients who required mechanical ventilation ≥ 24 hours between July 2014 and January 2016. No interventions were performed...
December 7, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29226131/risk-factors-of-delirium-in-sequential-sedation-patients-in-intensive-care-units
#2
Jie Yang, Yongfang Zhou, Yan Kang, Binbin Xu, Peng Wang, Yinxia Lv, Zhen Wang
Background: Delirium is a primary adverse event in ventilated patients who receive long-term monosedative treatment. Sequential sedation may reduce these adverse effects. This study evaluated risk factors for delirium in sequential sedation patients. Methods: A total of 141 patients who underwent sequential sedation were enrolled. Delirium was diagnosed using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale. Univariate and multivariate Cox proportional hazards regressions were used to predict risk factors...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29223744/effect-of-various-antipsychotic-regimens-on-incidence-of-delirium-in-critically-ill-adults
#3
W Anthony Hawkins, Stephanie V Phan, Stacey L Campbell
PURPOSE: Delirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens. MATERIALS AND METHODS: Single center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29221748/hydroxyethyl-starch-is-associated-with-early-postoperative-delirium-in-patients-undergoing-esophagectomy
#4
Dae Myung Jung, Hyun Joo Ahn, Mikyung Yang, Jie Ae Kim, Duck Kyung Kim, Sangmin Maria Lee, Joo Hyun Park
OBJECTIVE: Postoperative delirium is associated with longer hospital stay and increased morbidities. Patients undergoing esophagectomy have a high chance of developing postoperative delirium because of their advanced age, comorbidities, and intensive care unit care. In this study, we investigated the risk factors of early postoperative delirium in patients undergoing esophagectomy, focusing on perioperative fluid type to test the hypothesis that colloids with high oncotic pressure and anti-inflammatory action would decrease the incidence of postoperative delirium compared with crystalloids...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29207426/-management-of-delirium-in-the-intensive-care-unit
#5
Stephan Braune, Simone Gurlit
No abstract text is available yet for this article.
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29202534/-investigation-of-doctors-and-nurses-perceptions-and-implementation-of-delirium-management-in-intensive-care-unit
#6
H B Luo, X T Wang, B Tang, Z N Zhu, H L Guo, Z Z Li, J H Sun, D W Liu
Objective: To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods: A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results: There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management(P< 0...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29202254/incidence-correlates-and-outcomes-associated-with-falls-in-the-intensive-care-unit-a-retrospective-cohort-study
#7
Drayton Trumble, Michael A Meier, Maryellen Doody, Xiaoming Wang, Sean M Bagshaw
BACKGROUND: Falls among hospitalised patients contribute to avoidable morbidity and prolonged hospital stay. We aimed to describe the incidence, circumstances and outcomes associated with patient falls occurring in intensive care units. METHODS: Retrospective cohort study of adult admissions to an academic, tertiary ICU in Edmonton, Canada between 1 January 2013 and 30 April 2016. Fall events were ascertained by interrogation of an electronic health record. Each fall was independently adjudicated by two intensivists to confirm that a fall did occur, and to determine if the fall was potentially avoidable...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29196594/perceptions-of-families-of-intensive-care-unit-patients-regarding-involvement-in-delirium-prevention-activities-a-qualitative-study
#8
Pamela L Smithburger, Amanda S Korenoski, Sheila A Alexander, Sandra L Kane-Gill
BACKGROUND: Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. OBJECTIVE: To gain insight into opinions of patients' families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients' families in such activities...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29196587/perceptions-of-family-members-nurses-and-physicians-on-involving-patients-families-in-delirium-prevention
#9
Pamela L Smithburger, Amanda S Korenoski, Sandra L Kane-Gill, Sheila A Alexander
BACKGROUND: Delirium occurs in up to 80% of patients admitted to an intensive care unit. Nonpharmacologic delirium-prevention strategies, which are commonly used by the bedside nurse, have reduced the incidence and duration of delirium in patients in the intensive care unit. With increasing demands on the nurse, strategies such as including the patient's family in delirium prevention activities should be investigated. OBJECTIVE To determine opinions and willingness of health care providers to involve patients' families in nonpharmacologic delirium-prevention activities in the intensive care unit, and of patients' families to be involved...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29196586/implementing-a-multicomponent-intervention-to-prevent-delirium-among-critically-ill-patients
#10
Felipe Martínez, Ana María Donoso, Carla Marquez, Eduardo Labarca
BACKGROUND: Delirium is common among the critically ill. Nonpharmacologic interventions are reportedly effective in reducing incident delirium, but limited data specific to this population exist. OBJECTIVES: To assess the efficacy and describe the implementation strategy of a multicomponent intervention to prevent delirium in an intensive care unit. METHODS: A before-and-after study was conducted in an intensive care unit between May 2014 through August 2015...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29196585/feasibility-of-a-nurse-managed-pain-agitation-and-delirium-protocol-in-the-surgical-intensive-care-unit
#11
Alan Rozycki, Andrew S Jarrell, Rachel M Kruer, Samantha Young, Pedro A Mendez-Tellez
BACKGROUND: Society of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed. OBJECTIVES: To evaluate the percentage of adherent medication interventions for patients assessed by using a pain, sedation, and delirium protocol. METHODS: Data on all adult patients admitted to a surgical intensive care unit from January 2013 through September 2013 who were assessed at least once by using a pain, sedation, and delirium protocol were retrospectively reviewed...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29194171/improving-the-accuracy-of-delirium-assessments-in-neuroscience-patients-scaling-a-quality-improvement-program-to-improve-nurses-skill-compliance-and-accuracy-in-the-use-of-the-confusion-assessment-method-in-the-intensive-care-unit-tool
#12
Justin DiLibero, Susan DeSanto-Madeya, Rachael Dottery, Lauren Sullivan, Sharon C O'Donoghue
BACKGROUND: Delirium affects up to 80% of critically ill patients; however, many cases of delirium go unrecognized because of inaccurate assessments. The effectiveness of interventions to improve assessment accuracy among the general population has been established, but assessments among neuroscience patients are uniquely complicated due to the presence of structural neurologic changes. OBJECTIVES: The purposes of this quality improvement project were to improve the accuracy of nurse's delirium assessments among neuroscience patients and to determine the comparative effectiveness of the intervention between medical and neuroscience patients...
January 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29187230/decreasing-delirium-through-music-ddm-in-critically-ill-mechanically-ventilated-patients-in-the-intensive-care-unit-study-protocol-for-a-pilot-randomized-controlled-trial
#13
Sikandar H Khan, Sophia Wang, Amanda Harrawood, Stephanie Martinez, Annie Heiderscheit, Linda Chlan, Anthony J Perkins, Wanzhu Tu, Malaz Boustani, Babar Khan
BACKGROUND: Delirium is a highly prevalent and morbid syndrome in intensive care units (ICUs). Changing the stressful environment within the ICU via music may be an effective and a scalable way to reduce the burden of delirium. METHODS/DESIGN: The Decreasing Delirium through Music (DDM) study is a three-arm, single-blind, randomized controlled feasibility trial. Sixty patients admitted to the ICU with respiratory failure requiring mechanical ventilation will be randomized to one of three arms (20 participants per arm): (1) personalized music, (2) non-personalized relaxing music, or (3) attention-control...
November 29, 2017: Trials
https://www.readbyqxmd.com/read/29185354/validation-and-psychometric-properties-of-the-german-version-of-the-delirium-motor-subtype-scale-dmss
#14
David Garcia Nuñez, Soenke Boettger, Rafael Meyer, André Richter, Maria Schubert, David Meagher, Josef Jenewein
OBJECTIVE: Delirium has been characterized into its subtypes-hypoactive, hyperactive, mixed, or no motor subtype-along with the use of the Delirium Motor Symptom Scale (DMSS). The German version of this scale (DMSS-G), however, has not yet been validated. METHOD: We determined internal consistency, reliability, and validity of the DMSS-G in the surgical intensive care unit, using DSM-IV-TR criteria and the Delirium Rating Scale-Revised-98. RESULTS: In total, 289 patients were included, and out of these, 122 were delirious...
November 1, 2017: Assessment
https://www.readbyqxmd.com/read/29184454/sleep-quality-and-circadian-rhythm-disruption-in-the-intensive-care-unit-a-review
#15
REVIEW
Yuliya Boyko, Poul Jennum, Palle Toft
Sleep and circadian rhythm are reported to be severely abnormal in critically ill patients. Disturbed sleep can lead to the development of delirium and, as a result, can be associated with prolonged stay in the intensive care unit (ICU) and increased mortality. The standard criterion method of sleep assessment, polysomnography (PSG), is complicated in critically ill patients due to the practical challenges and interpretation difficulties. Several PSG sleep studies in the ICU reported the absence of normal sleep characteristics in many critically ill patients, making the standard method of sleep scoring insufficient in this patient group...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29148046/delirium-and-effect-of-circadian-light-in-the-intensive-care-unit-a-retrospective-cohort-study
#16
S Estrup, C K W Kjer, L M Poulsen, I Gøgenur, O Mathiesen
BACKGROUND: Delirium is a serious condition often experienced by critically ill patients in intensive care units (ICUs). The role of circadian light for this condition is unclear. The aim of this study was to describe incidence of delirium, risk factors for delirium, and the association between delirium and circadian light for patients in the ICU. METHODS: This is a retrospective cohort study of all patients at a Danish ICU from 1 August 2015 to 31 January 2016...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29138544/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patients-aged-over-70-years-with-displaced-femoral-neck-fracture
#17
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#18
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132782/midterm-outcomes-after-postoperative-delirium-on-cognition-and-mood-in-patients-after-cardiac-surgery
#19
Quyen Nguyen, Kelsey Uminski, Brett M Hiebert, Navdeep Tangri, Rakesh C Arora
OBJECTIVE: Delirium is a common neurologic complication after cardiac surgery. Our primary objective was to determine the impact of delirium on self-reported problems with midterm cognitive functioning and mood postcardiac surgery. METHODS: A single-center, prospective cohort study was conducted, enrolling 197 patients undergoing coronary artery bypass grafting or valve replacement. Baseline cognition and mood were assessed preoperatively in elective patients as a part of routine care using the Montreal Cognitive Assessment and Patient Health Questionnaire 9, respectively...
October 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29132506/intensive-care-unit-delirium-and-intensive-care-unit-related-posttraumatic-stress-disorder
#20
REVIEW
Annachiara Marra, Pratik P Pandharipande, Mayur B Patel
Delirium is one of the most common behavioral manifestations of acute brain dysfunction in the intensive care unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools. In delirious patients, a search for all reversible precipitants is the first line of action and pharmacologic treatment should be considered when all causes have been ruled out, and it is not contraindicated. Long-term morbidity has significant consequences for survivors of critical illness and for their caregivers...
December 2017: Surgical Clinics of North America
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