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https://www.readbyqxmd.com/read/29664005/-research-advances-in-ways-to-evaluate-delirium-in-intensive-care-unit
#1
Xueyan Zhang, Huanzhang Shao, Xin Dong, Bingyu Qin
In recent years, more and more attention has been paid to the occurrence and harm of delirium, and intensive care unit (ICU) delirium has become a hot issue. The incidence of delirium in ICU patients is much higher than that of general wards, all kinds of complications caused by delirium and increased mortality should win enough attention of the clinicians. There is no uniform standard for the diagnosis and evaluation of ICU delirium, which is a major problem that affects clinicians in the early diagnosis and assessment of prognosis...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29657370/delirium-in-the-intensive-care-unit-incidence-risk-factors-and-impact-on-outcome
#2
Nejla Tilouche, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Oussamma Jaoued, Rim Gharbi, S Souheil El Atrous
Background: The incidence and risk factors for delirium vary among studies. Objective: We aimed to determine the incidence, risk factors, and impact on outcome of delirium in a medical Intensive Care Unit (ICU) in Tunisia using a prospective observational study. Patients: All consecutive patients admitted to the ICU between May 2012 and April 2013 were included if they were aged more than 18 years and had an ICU stay of more than 24 h. Patients who had a cardiac arrest or have a history of dementia or psychosis were excluded...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29649027/pain-and-its-long-term-interference-of-daily-life-after-critical-illness
#3
Christina J Hayhurst, Jim C Jackson, Kristin R Archer, Jennifer L Thompson, Rameela Chandrasekhar, Christopher G Hughes
BACKGROUND: Persistent pain likely interferes with quality of life in survivors of critical illness, but data are limited on its prevalence and risk factors. We sought to determine the prevalence of persistent pain after critical illness and its interference with daily life. Additionally, we sought to determine if intensive care unit (ICU) opioid exposure is a risk factor for its development. METHODS: In a cohort of adult medical and surgical ICU survivors, we used the brief pain inventory (BPI) to assess pain intensity and pain interference of daily life at 3 and 12 months after hospital discharge...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628826/dexmedetomidine-vs-morphine-and-midazolam-in-the-prevention-and-treatment-of-delirium-after-adult-cardiac-surgery-a-randomized-double-blinded-clinical-trial
#4
Tamer M Abdel Azeem, Nahed E Yosif, Adel M Alansary, Ibrahim Mamdouh Esmat, Ahmed K Mohamed
Background: The aim of this clinical study was to evaluate the efficacy of neurobehavioral, hemodynamics and sedative characteristics of dexmedetomidine compared with morphine and midazolam-based regimen after cardiac surgery at equivalent levels of sedation and analgesia in improving clinically relevant outcomes such as delirium. Methods: Sixty patients were randomly allocated into one of two equal groups: group A = 30 patients received dexmedetomidine infusion (0...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29625595/psychometric-properties-of-the-arabic-version-of-the-confusion-assessment-method-for-the-intensive-care-unit-cam-icu
#5
Maha H Aljuaid, Ahmad M Deeb, Maamoun Dbsawy, Daniah Alsayegh, Moteb Alotaibi, Yaseen M Arabi
BACKGROUND: It is recommended that critically ill patients undergo routine delirium monitoring with a valid and reliable tool such as the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). However, the validity and reliability of the Arabic version of the CAM-ICU has not been investigated. Here, we test the validity and reliability of the Arabic CAM-ICU. METHODS: We conducted a psychometric study at ICUs in a tertiary-care hospital in Saudi Arabia...
April 6, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29609489/long-term-sequelae-of-acute-respiratory-distress-syndrome-caused-by-severe-community-acquired-pneumonia-delirium-associated-cognitive-impairment-and-post-traumatic-stress-disorder
#6
Claudia Denke, Felix Balzer, Mario Menk, Sebastian Szur, Georg Brosinsky, Sascha Tafelski, Klaus-Dieter Wernecke, Maria Deja
Objective Delirium in critically ill patients is considered a risk factor for various long-term consequences. We evaluated delirium and associated long-term outcomes in patients with acute respiratory distress syndrome with non-H1N1 and H1N1- associated severe community-acquired pneumonia (sCAP) who had been recommended to take antiviral drugs associated with delirious symptoms as adverse effects. Methods Of 64 patients, 42 survivors (H1N1, 15; non-H1N1, 27) were analyzed regarding the relationship between medication and the duration of delirium in the intensive care unit...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29607710/comparison-of-ketamine-versus-nonketamine-based-sedation-on-delirium-and-coma-in-the-intensive-care-unit
#7
Vanessa Shurtleff, John J Radosevich, Asad E Patanwala
BACKGROUND: At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE: The objective of this study was to evaluate the number of days alive without delirium or coma in mechanically ventilated patients in the intensive care unit receiving analgosedation infusions with ketamine versus without ketamine...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29606481/frequency-and-risk-factors-for-subsyndromal-delirium-in-an-intensive-care-unit
#8
Chikayo Yamada, Yoko Iwawaki, Kiyomi Harada, Michihiko Fukui, Masafumi Morimoto, Ryuya Yamanaka
OBJECTIVE: Delirium and subsyndromal delirium in critically ill patients are important determinants of long-term functional disability and cognitive impairment. However, few outcome studies on sub-syndromal delirium have been reported. Thus, this study aimed to evaluate the incidence of delirium and sub-syndromal delirium as well as the risk factors and progression to delirium. DESIGN: A prospective cohort study. SETTING: Six bed medical and surgical intensive care unit in Otsu Municipal Hospital in Japan...
March 29, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29603815/the-relationship-of-delirium-and-risk-factors-in-cardiology-intensive-care-unit-patients-with-the-nursing-workload
#9
A Öztürk Birge, T Bedük
AIMS AND OBJECTIVES: The aim of the study is to evaluate the relationship of delirium and risk factors in cardiology intensive care unit (ICU) patients with the nursing workload. BACKGROUND: Delirium is a common syndrome in patients with cardiac problems. The risk factors causing delirium and the presence and type of delirium affect the nurse workload and patient care quality adversely. DESIGN: This cross-sectional study was conducted with 133 patients staying at the cardiology ICU of a university hospital between January 5 and March 31, 2017...
March 31, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29602617/association-between-delirium-and-prehospitalization-medication-in-poststroke-patients
#10
Ryuichiro Hosoya, Yohei Sato, Emika Ishida, Haruna Shibamoto, Seiichi Hino, Hiroaki Yokote, Tomoyuki Kamata
PURPOSE: Medication is an important risk factor for delirium; however, the association between delirium and prehospitalization medication is unclear. We investigated the association between prestroke medication and poststroke delirium. MATERIALS AND METHODS: All patients hospitalized in the stroke care unit from September 2011 to September 2012 were selected, and their delirium symptoms, patient information, and pre- and poststroke medications were analyzed. Delirium was defined as a score of  4 or higher on the Intensive Care Delirium Screening Checklist...
March 27, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29602189/e-screening-revolution-a-novel-approach-to-developing-a-delirium-screening-tool-in-the-intensive-care-unit
#11
Eamonn Eeles, Hayley Gunn, Anna-Liisa Sutt, Donna Pinsker, Dylan Flaws, Paul Jarrett, India Lye, John F Fraser
OBJECTIVES: Delirium is common in the intensive care unit (ICU), often affecting older patients. A bedside electronic tool has the potential to revolutionise delirium screening. Our group describe a novel approach to the design and development of delirium screening questions for the express purpose of use within an electronic device. Preliminary results are presented. METHODS: Our group designed a series of tests which targeted the clinical criteria for delirium according to Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) criteria against predefined requirements, including applicability to older patients...
March 30, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29596297/innovation-in-clinical-practice-a-preliminary-study-on-delirium-assessment-in-intensive-care-unit-using-an-application-for-smartphone
#12
Gian Domenico Giusti, Marco Proietti Righi, Stefano Bambi
No abstract text is available yet for this article.
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29592860/extended-visitation-policy-may-lower-risk-for-delirium-in-the-intensive-care-unit
#13
Manuel Schwanda, Rita Gruber
No abstract text is available yet for this article.
March 28, 2018: Evidence-based Nursing
https://www.readbyqxmd.com/read/29580965/designing-a-nurse-delivered-delirium-bundle-what-intensive-care-unit-staff-survivors-and-their-families-think
#14
Leona Bannon, Jennifer McGaughey, Mike Clarke, Daniel F McAuley, Bronagh Blackwood
BACKGROUND: Implementation of quality improvement interventions can be enhanced by exploring the perspectives of those who will deliver and receive them. We designed a non-pharmacological bundle for delirium management for a feasibility trial, and we sought to obtain the views of intensive care unit (ICU) staff, survivors, and families on the barriers and facilitators to its implementation. OBJECTIVE: The objective of this study is to determine the barriers and facilitators to a multicomponent bundle for delirium management in critically ill patients comprising (1) education and family participation, (2) sedation minimisation and pain, agitation, and delirium protocol, (3) early mobilisation, and (4) environmental interventions for sleep, orientation, communication, and cognitive stimulation...
March 23, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29580772/acute-brain-dysfunction-development-and-validation-of-a-daily-prediction-model
#15
Annachiara Marra, Pratik P Pandharipande, Matthew S Shotwell, Rameela Chandrasekhar, Timothy D Girard, Ayumi K Shintani, Linda M Peelen, Karl Moons, Robert S Dittus, E Wesley Ely, Eduard E Vasilevskis
BACKGROUND: To develop and validate a dynamic risk model to predict daily changes in acute brain dysfunction (i.e., delirium and coma), discharge and mortality in intensive care unit (ICU) patients. METHODS: Using data from a multicenter prospective ICU cohort, we developed a daily Acute Brain Dysfunction-prediction model (ABD-pm) using multinomial logistic regression that estimated 15 transition probabilities (from 1 of 3 brain function states [normal, delirious, or comatose] to 1 of 5 possible outcomes [normal, delirious, comatose, ICU discharge, and dead]) using baseline and daily risk factors...
March 23, 2018: Chest
https://www.readbyqxmd.com/read/29580264/improving-recovery-and-outcomes-every-day-after-the-icu-improve-study-protocol-for-a-randomized-controlled-trial
#16
Sophia Wang, Jessica Hammes, Sikandar Khan, Sujuan Gao, Amanda Harrawood, Stephanie Martinez, Lyndsi Moser, Anthony Perkins, Frederick W Unverzagt, Daniel O Clark, Malaz Boustani, Babar Khan
BACKGROUND: Delirium affects nearly 70% of older adults hospitalized in the intensive care unit (ICU), and many of those will be left with persistent cognitive impairment or dementia. There are no effective and scalable recovery models to remediate ICU-acquired cognitive impairment and its attendant elevated risk for dementia or Alzheimer disease (AD). The Improving Recovery and Outcomes Every Day after the ICU (IMPROVE) trial is an ongoing clinical trial which evaluates the efficacy of a combined physical exercise and cognitive training on cognitive function among ICU survivors 50 years and older who experienced delirium during an ICU stay...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29574851/dexmedetomidine-induced-fever-and-delirium-a-case-report
#17
L B Straw, C R Dodson, D S Schrift
WHAT IS KNOWN AND OBJECTIVE: Dexmedetomidine is a selective alpha-2 agonist used for sedation in the intensive care unit (ICU). CASE DESCRIPTION: A 41-year-old woman intubated in the ICU and being treated for acute respiratory distress syndrome (ARDS) received dexmedetomidine following successful extubation to treat increasing agitation thought to be secondary to a history of polysubstance abuse. Following initiation of the dexmedetomidine, the patient became febrile as well as increasingly more agitated and delirious...
March 25, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29571595/-sedation-is-tricky-a-qualitative-content-analysis-of-nurses-perceptions-of-sedation-administration-in-mechanically-ventilated-intensive-care-unit-patients
#18
Breanna Hetland, Jill Guttormson, Mary Fran Tracy, Linda Chlan
INTRODUCTION: Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients...
March 20, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29566803/conscious-sedation-versus-general-anesthesia-in-transcatheter-aortic-valve-replacement-the-german-aortic-valve-registry
#19
Oliver Husser, Buntaro Fujita, Christian Hengstenberg, Christian Frerker, Andreas Beckmann, Helge Möllmann, Thomas Walther, Raffi Bekeredjian, Michael Böhm, Costanza Pellegrini, Sabine Bleiziffer, Rüdiger Lange, Friedrich Mohr, Christian W Hamm, Timm Bauer, Stephan Ensminger
OBJECTIVES: The aims of this study were to report on the use of local anesthesia or conscious sedation (LACS) and general anesthesia in transcatheter aortic valve replacement and to analyze the impact on outcome. BACKGROUND: Transcatheter aortic valve replacement can be performed in LACS or general anesthesia. Potential benefits of LACS, such as faster procedures and shorter hospital stays, need to be balanced with safety. METHODS: A total of 16,543 patients from the German Aortic Valve Registry from 2011 to 2014 were analyzed, and propensity-matched analyses were performed to correct for potential selection bias...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29561076/benefits-of-quiet-time-interventions-in-the-intensive-care-unit-a-literature-review
#20
Rimen Lim
Sleep disturbance is a significant issue for patients in intensive care units (ICUs), which can affect their health and recovery from illness. Therefore, it is important to consider ways to address sleep disturbance in these settings. One strategy that has been suggested is the use of 'quiet time' interventions, which involve a defined period where there is a reduction in controllable light and sound, and where interruptions at the patient's bedside are minimised. AIM: To determine the effectiveness of quiet time interventions in improving patients' sleep quality in ICUs; to investigate other potential clinical benefits of quiet time interventions; and to consider the effect of incorporating open visitation when implementing quiet time interventions...
March 21, 2018: Nursing Standard
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