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intensive care unit delirium

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https://www.readbyqxmd.com/read/27912904/changes-of-geriatric-syndromes-in-older-adults-survived-from-intensive-care-unit
#1
Hsin-Ju Tang, Hsin-Yi Jean Tang, Fang-Wen Hu, Ching-Huey Chen
Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline...
November 29, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#2
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#3
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27900414/-comment-on-dexmedetomidine-for-delirium-prophylaxis-in-elderly-patients-after-non-cardiac-surgery-in-the-intensive-care-unit
#4
J Van Waesberghe, A Eisert, M Coburn
No abstract text is available yet for this article.
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27899718/postoperative-delirium-after-liver-transplantation-is-associated-with-increased-length-of-stay-and-lower-survival-in-a-prospective-cohort
#5
Sonja Beckmann, Maria Schubert, Hanna Burkhalter, Philipp Dutkowski, Sabina De Geest
INTRODUCTION: Although postoperative delirium (POD) is a common in-hospital complication associated with negative outcomes, evidence in liver transplantation (LT) is scarce. OBJECTIVE: We examined the incidence and duration of POD, its impact on outcomes and health-care utilization, and described predisposing and precipitating factors favoring POD development. DESIGN: This prospective cohort study included adults undergoing transplantation in a tertiary hospital...
November 28, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27891229/nicotine-replacement-therapy-for-agitation-and-delirium-management-in-the-intensive-care-unit-a-systematic-review-of-the-literature
#6
Melanie Kowalski, Andrew A Udy, Hayden J McRobbie, Michael J Dooley
BACKGROUND: Active smokers are prevalent within the intensive care setting and place a significant burden on healthcare systems. Nicotine withdrawal due to forced abstinence on admission may contribute to increased agitation and delirium in this patient group. The aim of this systematic review was to determine whether management of nicotine withdrawal, with nicotine replacement therapy (NRT), reduces agitation and delirium in critically ill patients admitted to the intensive care unit (ICU)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27881149/antipsychotic-prescribing-patterns-during-and-after-critical-illness-a-prospective-cohort-study
#7
Jason E Tomichek, Joanna L Stollings, Pratik P Pandharipande, Rameela Chandrasekhar, E Wesley Ely, Timothy D Girard
BACKGROUND: Antipsychotics are used to treat delirium in the intensive care unit (ICU) despite unproven efficacy. We hypothesized that atypical antipsychotic treatment in the ICU is a risk factor for antipsychotic prescription at discharge, a practice that might increase risk since long-term use is associated with increased mortality. METHODS: After excluding patients on antipsychotics prior to admission, we examined antipsychotic use in a prospective cohort of ICU patients with acute respiratory failure and/or shock...
November 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27850876/1240-improving-recognition-and-management-of-delirium-in-the-medical-intensive-care-unit
#8
Lisa Daniels, John Park, James Skiba, Shannon Piche, Sarah Nelson, Jennifer Elmer, Catherine Bowron
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850874/1238-a-nursing-survey-of-protocol-based-pain-sedation-and-delirium-management-in-an-intensive-care-unit
#9
Kerra Cissne, Allegra Durrant, Erin Pender, Muhammad Ali Javed
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850852/1216-effects-of-implementing-delirium-screening-in-a-pediatric-intensive-care-unit
#10
Teia Brandenburg, Andrea Chamberlain, Ranjit Chima
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850549/911-melatonin-for-the-prevention-of-intensive-care-unit-delirium
#11
Laura Baumgartner
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850513/875-development-and-implementation-of-a-delirium-protocol-in-the-surgical-trauma-intensive-care-unit
#12
Lesly Jurado, Danine Sullinger, Alexander Gilmer, Lisa Hall Zimmerman, Joshua Steelman, Elizabeth Acquista
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#13
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27846169/decreased-incidence-of-postoperative-delirium-in-robot-assisted-thoracoscopic-esophagectomy-compared-with-open-transthoracic-esophagectomy
#14
Dae Myoung Jeong, Jie Ae Kim, Hyun Joo Ahn, Mikyung Yang, Burn Young Heo, Soo Hee Lee
BACKGROUND: Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy. MATERIALS AND METHODS: A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529)...
November 14, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27824784/use-of-expert-consultation-in-a-complex-case-of-neuroleptic-malignant-syndrome-requiring-electroconvulsive-therapy
#15
Justine Wittenauer Welsh, A Umair Janjua, Steven J Garlow, Laurie McCormick, Mustafa M Husain, Daniel F Maixner, Richard D Weiner, Adriana P Hermida
Our team at Emory University Hospital contacted experts at the National Network of Depression Centers (NNDC) for clinical guidance concerning a patient with schizophrenia hospitalized in the intensive care unit with a complex case of prolonged delirium secondary to neuroleptic malignant syndrome (NMS). Through the NNDC, leading psychiatrists across the United States with expertise in electroconvulsive therapy (ECT) provided us with treatment strategies based on experience in our area of concern. This report describes our use of ECT to treat severe NMS in this patient with schizophrenia, utilizing the recommendations made by the NNDC's ECT experts concerning electrode position, number and frequency of treatments, and selection of anesthetic induction agents...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27821819/-effect-of-ultra-fast-track-extubation-in-cardiovascular-surgery
#16
Toshiro Kobayashi, Hiroshi Kurazumi, Hidenori Gohra, Seiichi Shibasaki, Yuko Kudo, Naoko Yamauchi, Takashi Tamura, Michio Shigedomi
Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.3%)were extubated in the OR. Five patients were re-intubated, but none were because of heart or respiratory failure. Independent predictors for failure of OR extubation were preoperative renal failure, pre-existent cerebrovascular disease, emergency surgery, and prolonged operation and/or cardiopulmonary bypass times...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27806548/jordanian-intensive-care-unit-nurses-knowledge-of-delirium-recognition
#17
Mohannad Eid AbuRuz
INTRODUCTION: Delirium is a clinical syndrome that negatively affects the outcomes of the intensive care units patients if undetected early and treated well. However, this condition remains under recognized and poorly managed by health care providers including nurses. The objective of this study was to check nurses' knowledge level about delirium recognition. MATERIALS & METHODS: This was a cross-sectional study on 176 intensive care units nurses working in four major hospitals in Amman, Jordan...
August 26, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27802955/effect-of-abcde-bundle-implementation-on-prevalence-of-delirium-in-intensive-care-unit-patients
#18
Mandy Bounds, Stacey Kram, Karen Gabel Speroni, Kim Brice, Mary Anne Luschinski, Stephanie Harte, Marlon G Daniel
BACKGROUND: The ABCDE bundle incorporates multidisciplinary measures to improve and/or preserve patients' physical, functional, and neurocognitive status through awakening and breathing coordination, delirium prevention and management, and early physical mobility. OBJECTIVES: To quantify the prevalence and duration of delirium in patients in the intensive care unit (ICU) before and after implementation of the ABCDE bundle. METHODS: Delirium prevalence was defined as the percentage of patients who had at least 1 positive delirium score on the Intensive Care Delirium Screening Checklist (ICDSC) during the ICU stay; delirium duration was the number of days during the ICU stay that a positive ICDSC score was noted...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27802952/detection-of-posttraumatic-stress-symptoms-in-patients-after-discharge-from-intensive-care
#19
Heather Warlan, Lois Howland, Cynthia Connelly
BACKGROUND: Despite emphasis on identifying personal and clinical characteristics that place patients at higher risk for posttraumatic stress syndrome after intensive care, the extent of screening for the syndrome in intensive care patients is unknown. OBJECTIVES: To examine the feasibility and acceptability of a screening tool to detect posttraumatic stress syndrome, screen for the syndrome soon after discharge from intensive care to identify patients at risk for post-traumatic stress disorder, and determine personal and clinical factors related to higher scores on the screening instrument...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27797086/risk-factors-for-new-onset-delirium-in-patients-with-bloodstream-infections-independent-and-quantitative-effect-of-catheters-and-drainages-a-four-year-cohort-study
#20
Tolga Dittrich, Sarah Tschudin-Sutter, Andreas F Widmer, Stephan Rüegg, Stephan Marsch, Raoul Sutter
BACKGROUND: Bloodstream infections (BSI) and delirium are frequent in critically ill patients. During systemic inflammatory response to BSI, cytokines may interact with neurotransmitters and neuronal receptors driving acute brain dysfunction. However, prospectively collected data on incidence, prediction and impact of delirium in association with BSI are lacking. This study aimed to determine the incidence and predictors of new-onset delirium and its impact on outcome in critically ill adult patients with BSI...
December 2016: Annals of Intensive Care
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