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intensive care unit delirium

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https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#1
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28539958/cognitive-impairment-and-psychological-distress-at-discharge-from-intensive-care-unit
#2
Chi Ryang Chung, Hye Jin Yoo, Jinkyeong Park, Seunghyong Ryu
This study aimed to investigate cognitive impairment and psychological distress of critically ill patients at discharge from intensive care unit (ICU). This study included 30 critically ill patients who had neither pre-existing dementia nor ongoing delirium. At ICU discharge, they performed a screening test for cognitive impairment (Mini-Cog test) and completed questionnaires for depression (Patient Health Questionnaire-2, PHQ-2) and for 4 stressful experiences during ICU stay including nightmares, severe anxiety or panic, severe pain, and trouble to breathe or feeling of suffocation (Post-Traumatic Stress Syndrome 14-Question Inventory, PTSS-14 Part A)...
May 2017: Psychiatry Investigation
https://www.readbyqxmd.com/read/28523698/survey-among-critical-care-nurses-and-physicians-about-delirium-management
#3
Peter Nydahl, Michael Dewes, Rolf Dubb, Carsten Hermes, Arnold Kaltwasser, Susanne Krotsetis, Rebecca von Haken
BACKGROUND: Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. AIM: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. DESIGN: The study used an open online survey with multiple-choice responses...
May 18, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28508438/the-effect-of-chronotherapy-on-delirium-in-critical-care%C3%A2-%C3%A2-a-systematic-review
#4
Roseanne Luther, Anne McLeod
BACKGROUND: Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. AIM: This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? DESIGN: This study is a systematic review of quantitative studies...
May 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28506741/evaluation-of-a-sound-environment-intervention-in-an-icu-a-feasibility-study
#5
Lotta Johansson, Berit Lindahl, Susanne Knutsson, Mikael Ögren, Kerstin Persson Waye, Mona Ringdal
BACKGROUND: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes. OBJECTIVES: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms...
May 12, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#6
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28497575/recognition-of-delirium-in-postoperative-elderly-patients-a-multicenter-study
#7
Tianne Numan, Mark van den Boogaard, Adriaan M Kamper, Paul J T Rood, Linda M Peelen, Arjen J C Slooter
OBJECTIVES: To evaluate to what extent delirium experts agree on the diagnosis of delirium when independently assessing exactly the same information and to evaluate the sensitivity of delirium screening tools in routine daily practice of clinical nurses. DESIGN: Prospective observational longitudinal study. SETTING: Three medical centers in the Netherlands. PARTICIPANTS: Elderly postoperative adults (n = 167). MEASUREMENTS: A researcher examined participants daily (Postoperative Day 1-3) for delirium using a standardized cognitive assessment and interview including the Delirium Rating Scale Revised-98 as global impression without any cut-off values that was recorded on video...
May 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28495595/low-plasma-leptin-level-at-admission-predicts-delirium-in-critically-ill-patients-a-prospective-cohort-study
#8
Guicheng Li, Xiaobao Lei, Chenmu Ai, Tao Li, Zhongqing Chen
The pathophysiology of delirium remains poorly understood. Low leptin level has been associated with features leading to delirium such as dysregulated immune functions and loss of neuroprotective effects. The purpose of the present study was to investigate the relationship between plasma leptin level at intensive care unit (ICU) entry and subsequent occurrence of delirium in critically ill patients. This single-center prospective cohort study in China allocated 336 critically ill patients admitted to ICU between 05/2015 and 05/2016 into a delirium group (n=102) and non-delirium group (n=234) based on whether delirium occurred during their stay at the ICU...
May 8, 2017: Peptides
https://www.readbyqxmd.com/read/28492463/impact-of-an-alcohol-withdrawal-treatment-pathway-on-hospital-length-of-stay-a-retrospective-observational-study-comparing-pre-and-post-pathway-implementation
#9
Andrew J Muzyk, Rachel E Rogers, Gary Dighe, Jessica Hartung, Robert C Musser, Mary J Stillwagon, Sarah Rivelli
OBJECTIVE: To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care. METHODS: This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28489131/incidence-of-delirium-in-postoperative-patients-treated-with-total-knee-and-hip-arthroplasty
#10
Felipe de Santana Bosmak, Patrick Teller Gibim, Sandra Guimarães, Adriano Luiz Ammirati
Introduction: Delirium is a common disorder that can potentiate mortality and comorbidity rates of patients hospitalized in intensive care units. Patients undergoing major orthopedic surgeries, such as knee and hip arthroplasty, are particularly vulnerable as they often have multiple risk factors for this disorder. Method: Descriptive study of the incidence of delirium in patients treated with total knee and hip arthroplasty, given the advanced age and comorbidities in this population...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28485318/a-national-multicenter-survey-on-management-of-pain-agitation-and-delirium-in-intensive-care-units-in-china
#11
Jing Wang, Zhi-Yong Peng, Wen-Hai Zhou, Bo Hu, Xin Rao, Jian-Guo Li
BACKGROUND: The management of pain, agitation, and delirium (PAD) in Intensive Care Unit (ICU) is beneficial for patients and makes it widely applied in clinical practice. Previous studies showed that the clinical practice of PAD in ICU was improving; yet relatively little information is available in China. This study aimed to investigate the practice of PAD in ICUs in China. METHODS: A multicenter, nationwide survey was conducted using a clinician-directed questionnaire from September 19 to December 18, 2016...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28461551/organizational-domains-and-variation-in-attitudes-of-intensive-care-providers-toward-the-abcde-bundle
#12
Leanne M Boehm, Eduard E Vasilevskis, Mary S Dietrich, Nancy Wells, E Wesley Ely, Pratik Pandharipande, Lorraine C Mion
BACKGROUND: The ABCDE interprofessional bundle (Awakening and Breathing Coordination, Delirium monitoring and management, and Early mobility) reduces delirium and weakness in critically ill patients. OBJECTIVE: To understand the relationship between organizational domains and provider attitudes. METHODS: A 1-time electronic survey of 315 care providers in 10 intensive care units across the country to examine associations between organizational domains (policy/protocol factors, unit milieu, tasks, labor quality, labor quantity, and physical environment) and provider attitudes about perceived ease of completion, perceived safety, confidence, and perceived strength of evidence regarding the ABCDE bundle...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28459497/assessment-of-delirium-in-intensive-care-unit-patients-educational-strategies
#13
Judith M Smith, M Nancy Van Aman, Mary Elizabeth Schneiderhahn, Robin Edelman, Patrick M Ercole
BACKGROUND: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently. METHOD: A pretest-posttest design was used to evaluate the success of a multimodal educational strategy (i...
May 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28448322/dexmedetomidine-as-a-rescue-therapy-for-emergence-delirium-in-adults-a-case-series
#14
Matthew D Read, Christopher V Maani, Scott Blackwell
Emergence delirium (ED) in adult patients encountered in the postanesthesia care unit (PACU) is not well studied; nor are ED treatment strategies. Similar to delirium in the intensive care unit, ED in the PACU can result in serious complications. We describe 3 cases of ED in the PACU in patients with a history of posttraumatic stress disorder who were successfully treated with dexmedetomidine. Although likely utilized more frequently in recent years, the use of dexmedetomidine in the PACU for treatment of ED is not established in the literature...
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28443974/nurses-training-in-the-use-of-a-delirium-screening-tool
#15
Regina Cláudia da Silva Souza, Mariana Davies Ribeiro Bersaneti, Ellen Maria Pires Siqueira, Luciana Meira, Daiana Lepre Brumatti, Nilda Rosa de Oliveira Prado
Objective: To narrate the nurses' training experience in the implementation of a systematic delirium screening tool using the Confusion Assessment Method for Intensive Care Unit. Method: Experience report covering the steps of situation diagnosis, planning, staff training and evaluation of the tool's implementation between January and March 2013 with nurses in the ICU of a tertiary hospital in São Paulo. Results: The implementation of the assessment, using the Confusion Assessment Method for Intensive Care Unit, obtained significant nurse adhesion and became a service indicator...
April 20, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28438605/identifying-barriers-to-delivering-the-abcde-bundle-to-minimize-adverse-outcomes-for-mechanically-ventilated-patients-a-systematic-review
#16
Deena Kelly Costa, Matthew White, Emily Ginier, Milisa Manojlovich, Sushant Govindan, Theodore J Iwashyna, Anne E Sales
BACKGROUND: Improved outcomes are associated with the Awakening, Breathing Coordination, Delirium and Early mobility/exercise (ABCDE) bundle; however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and provide a resource to guide clinicians in overcoming barriers to implementation...
April 21, 2017: Chest
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#17
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
May 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28434804/nurses-knowledge-and-perception-of-delirium-screening-and-assessment-in-the-intensive-care-unit-long-term-effectiveness-of-an-education-based-knowledge-translation-intervention
#18
Sharon L Hickin, Sandra White, Jennifer Knopp-Sihota
OBJECTIVES: To determine the impact of education on nurses' knowledge of delirium, knowledge and perception of a validated screening tool, and delirium screening in the ICU. METHODS: A quasi-experimental single group pretest-post-test design. SETTING: A 16 bed ICU in a Canadian urban tertiary care centre. MAIN OUTCOME MEASURES: Nursing knowledge and perception were measured at baseline, 3-month and 18-month periods. Delirium screening was then assessed over 24-months...
April 20, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#19
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28412481/environmental-and-clinical-risk-factors-for-delirium-in-a-neurosurgical-center-a-prospective-study
#20
Fumihiro Matano, Takayuki Mizunari, Keiko Yamada, Shiro Kobayashi, Yasuo Murai, Akio Morita
INTRODUCTION: Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging (MRI) FLAIR images. MATERIAL & METHODS: We prospectively enrolled 253 patients admitted to our neurosurgical center between December 2014 and June 2015 and analyzed a total of 220 patients (100 males; mean age, 64.1 years; age range, 17-92 years). The upper 4 points of the Intensive Care Delirium Screening Checklist (ICDSC) indicated delirium...
April 12, 2017: World Neurosurgery
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