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pediatric delirium

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https://www.readbyqxmd.com/read/29784261/reduction-of-postanesthetic-pediatric-distress-a-coordinated-approach
#1
Simon Hayhoe, Scott Pallett, Juliet Zani, Joanne Trott
PURPOSE: Preoperative anxiety in children is associated with postoperative distress in recovery. Both are predictors of long-term maladaptive behavior. Remedies have been suggested to modify individual risk factors, but overall strategy is lacking. DESIGN: An approach to anxiety reduction coordinated throughout the hospital experience has been developed in our day-stay pediatric surgical unit. METHODS: There is a preadmission familiarization visit...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29752853/dexmedetomidine-for-the-reduction-of-emergence-delirium-in-children-undergoing-tonsillectomy-with-propofol-anesthesia-a-double-blind-randomized-study
#2
Adelais G Tsiotou, Anna Malisiova, Elena Kouptsova, Maria Mavri, Maria Anagnostopoulou, Evagelia Kalliardou
BACKGROUND: Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. METHODS: This was a prospective, single-center, double-blind, randomized study. The primary outcome was the presence or absence of emergence delirium with and without dexmedetomidine...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752842/correlation-between-duration-of-preoperative-fasting-and-emergence-delirium-in-pediatric-patients-undergoing-ophthalmic-examination-under-anesthesia-a-prospective-observational-study
#3
Puneet Khanna, Kulbhushan Saini, Renu Sinha, Niseville Nisa, Shailendra Kumar, Souvik Maitra
BACKGROUND: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. AIMS: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. METHODS: In this prospective observational study, 100 children between the age group 2-6 years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29742225/translation-and-cross-cultural-adaptation-of-the-pediatric-confusion-assessment-method-for-the-intensive-care-unit-into-brazilian-portuguese-for-the-detection-of-delirium-in-pediatric-intensive-care-units
#4
Marizete Elisa Molon, Roberta Esteves Vieira de Castro, Flávia Andrea Krepel Foronda, Maria Clara Magalhães-Barbosa, Jaqueline Rodrigues Robaina, Jefferson Pedro Piva, Pedro Celiny Ramos Garcia, Arnaldo Prata-Barbosa, Elie Cheniaux, Heidi A B Smith
OBJECTIVE: To undertake the translation and cross-cultural adaption into Brazilian Portuguese of the Pediatric Confusion Assessment Method for the Intensive Care Unit for the detection of delirium in pediatric intensive care units, including the algorithm and instructions. METHODS: A universalist approach for the translation and cross-cultural adaptation of health measurement instruments was used. A group of pediatric critical care specialists assessed conceptual and item equivalences...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29729659/improving-health-care-for-critically-ill-patients-using-an-evidence-based-collaborative-approach-to-abcdef-bundle-dissemination-and-implementation
#5
Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29727363/benzodiazepines-and-development-of-delirium-in-critically-ill-children-estimating-the-causal-effect
#6
Kalgi Mody, Savneet Kaur, Elizabeth A Mauer, Linda M Gerber, Bruce M Greenwald, Gabrielle Silver, Chani Traube
OBJECTIVES: Benzodiazepine use may be associated with delirium in critically ill children. However, benzodiazepines remain the first-line sedative choice in PICUs. Objectives were to determine the temporal relationship between administration of benzodiazepines and delirium development, control for time-varying covariates such as mechanical ventilation and opiates, and evaluate the association between dosage of benzodiazepines and subsequent delirium. DESIGN: Retrospective observational study...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29714431/emotion-regulation-and-premedication-success-relationship-in-children-who-underwent-general-anesthesia
#7
Aslıhan Aykut, Berrin Işık
Background/aim: This study aims to investigate the relationship between emotion regulation characteristics and the efficacy of midazolam premedication. Materials and methods: Sixty-three children, aged 3 to 8 years old, with tonsillectomy and/or adenoidectomy and taking premedication with midazolam (Group 2) or without premedication (Group 1), were included in this study. The behavioral and emotional status of the children was evaluated with the Conners Parent Rating Scale-48 (CPRS-48) and Emotion Regulation Checklist (ERC)...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29697715/catatonia-in-the-medically-ill-etiology-diagnosis-and-treatment-the-academy-of-consultation-liaison-psychiatry-evidence-based-medicine-subcommittee-monograph
#8
Lex Denysenko, Nicole Sica, Thomas M Penders, Kemuel L Philbrick, Audrey Walker, Scott Shaffer, Paula Zimbrean, Oliver Freudenreich, Nicole Rex, Brendan T Carroll, Andrew Francis
BACKGROUND: Catatonia in medically ill patients is rare but often unrecognized. This monograph summarizes current knowledge on the diagnosis, epidemiology, etiology, and management of catatonia occurring in the medical setting. METHODS: PubMed searches were used to identify relevant articles from 1962 to present. RESULTS: More than 3,000 articles were obtained and reviewed for relevance, including references of articles identified by the initial search...
May 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/29649402/end-of-life-treatments-in-pediatric-patients-at-a-government-tertiary-cancer-center-in-india
#9
Jean Jacob, Jaskirt K Matharu, Gayatri Palat, Sudha Sinha, Eva Brun, Thomas Wiebe, Mikael Segerlantz
AIM: The primary objective of this study was to describe demographics and end-of-life treatments of children with cancer at a government tertiary cancer center in India. METHODS: A retrospective review was undertaken of medical charts of all children younger than 18 years, who died as inpatients while undergoing treatment at the pediatric oncology department between April and September 2016. Data were collected on demographics, diagnosis, treatments, survival, palliative care involvement, and symptoms at end of life...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29570150/cost-effectiveness-research-in-anesthesiology
#10
Bijan J Teja, Tori N Sutherland, Sheila R Barnett, Daniel S Talmor
Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions. We excluded interventions related to critical care or pediatric anesthesiology, and articles on interventions not normally ordered or performed by anesthesiologists...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29543606/ce-original-research-recognizing-delirium-in-hospitalized-children-a-systematic-review-of-the-evidence-on-risk-factors-and-characteristics
#11
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
: Purpose: The purpose of this study was to examine the evidence regarding the risk factors for and characteristics of acute pediatric delirium in hospitalized children. METHODS: The systematic review method within an epidemiological framework of person, place, and time was used. Fifty-two studies were selected for initial retrieval. Of these, after assessment for methodological quality, 21 studies involving 2,616 subjects were included in the review. RESULTS: Findings revealed five primary characteristics seen in children experiencing delirium: agitation, disorientation, hallucinations, inattention, and sleep-wake cycle disturbances...
April 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29530328/clinical-characteristics-prevalence-and-factors-related-to-delirium-in-children-of-5-to-14-years-of-age-admitted-to-intensive-care
#12
C Ricardo Ramirez, M L Álvarez Gómez, C A Agudelo Vélez, S Zuluaga Penagos, R A Consuegra Peña, K Uribe Hernández, I C Mejía Gil, E M Cano Londoño, M Elorza Parra, J G Franco Vásquez
OBJECTIVE: To evaluate the clinical characteristics, prevalence and factors associated with delirium in critical patients from 5 to 14 years of age. DESIGN: An analytical, cross-sectional observational study was made. Delirium was assessed with the Pediatric-Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU) and motor classification was established with the Delirium Rating Scale Revised-98. SETTING: A pediatric Intensive Care Unit...
March 9, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29508484/a-psychometric-evaluation-of-the-pediatric-anesthesia-emergence-delirium-scale
#13
Jenny Ringblom, Ingrid Wåhlin, Marie Proczkowska
BACKGROUND: Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. AIMS: The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures...
April 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29445507/development-of-the-japanese-version-of-the-cornell-assessment-of-pediatric-delirium
#14
Haruhiko Hoshino, Yujiro Matsuishi, Nobutake Shimojo, Yuki Enomoto, Takahiro Kido, Yoshiaki Inoue
Aim: Delirium is a form of acute cerebral dysfunction and is associated with increased length of hospital stay, mortality, and health-care costs for adult patients in intensive care. However, in Japan, there are currently no reliable criteria or tools for diagnosing delirium in critically ill pediatric patients. The purpose of this study was to translate the Cornell Assessment of Pediatric Delirium (CAPD)-a screening tool for pediatric delirium-from English to Japanese for use in the diagnosis of delirium for pediatric patients in pediatric intensive care units...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29417691/incidence-risk-factors-and-outcomes-related-with-neurological-events-after-liver-transplantation-in-adult-and-pediatric-recipients
#15
Federico Piñero, Yu Cheang, Manuel Mendizabal, Joaquín Cagliani, Ariel Gonzalez Campaña, Josefina Pages, Carla Colaci, Mariano Barreiro, Cristina Alonso, Ivone Malla, Martín Fauda, Jose Bueri, Luis G Podesta, Marcelo Silva
Controversy exists whether NE after LT are more frequently observed in children or adults. We aimed to compare the incidence and outcomes for NE after LT in pediatric and adult recipients. A single-center cohort study, including all LT between 2001 and 2013, was performed. Definition of NE included impaired consciousness, delirium, seizures, focal neurologic deficit, visual impairment, or slurred speech. A cohort of 443 consecutive LT recipients was included: 307 adults and 136 children. Cumulative incidence of NE was similar between adults 15% (n = 41) and children 16% (n = 20; P = ...
May 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29405671/light-sedation-with-dexmedetomidine-a-practical-approach-for-the-intensivist-in-different-icu-patients
#16
Stefano Romagnoli, Angela Amigoni, Ilaria Blangetti, Giampaolo Casella, Cosimo Chelazzi, Francesco Forfori, Cristiana Garisto, Maria C Mondardini, Marco Moltrasio, Daniela Pasero, Tiziana Principi, Zaccaria Ricci, Fabio Tarantino, Giorgio Conti
Light sedation, corresponding to a Richmond AgitationSedation Scale between 0 and 1 is a priority of modern critical care practice. Dexmedetomidine, a highly selective, central, 2adrenoceptor agonist, is increasingly administered in the intensive care units (ICUs) as an effective drug to induce light sedation, analgesia and a quasiphysiological sleep in critically ill patients. Although in general dexmedetomidine is well tolerated, side effects as bradycardia, hypertension, and hypotension may occur. Although a general dosing range is suggested, different ICU patients may require different and highly precise titration that may significantly vary due to neurological status, cardiorespiratory function, baseline blood pressure, heart rate, liver efficiency, age and coadministration of other sedatives...
February 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29395177/delirium-is-a-common-and-early-finding-in-patients-in-the-pediatric-cardiac-intensive-care-unit
#17
Rita V Alvarez, Claire Palmer, Angela S Czaja, Chris Peyton, Gabrielle Silver, Chani Traube, Peter M Mourani, Jon Kaufman
OBJECTIVE: To determine incidence, associated risk factors, and characteristics of delirium in a pediatric cardiac intensive care unit (CICU). Delirium is a frequent and serious complication in adults after cardiac surgery, but there is limited understanding of its impact in children with critical cardiac disease. STUDY DESIGN: Single-center prospective observational study of CICU patients ≤21 years old. All were screened for delirium using the Cornell Assessment for Pediatric Delirium each 12-hour shift...
April 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29379311/postoperative-discomfort-and-emergence-delirium-in-children-undergoing-dental-rehabilitation-under-general-anesthesia-comparison-of-nasal-tracheal-intubation-and-laryngeal-mask-airway
#18
Sultan Keles, Ozlem Kocaturk
Background: Several studies have identified side effects of general anesthesia with endotracheal intubation, such as laryngeal pain, dysphonia, and postoperative nausea and vomiting (PONV). The laryngeal mask airway (LMAw) is believed to decrease these side effects. The aim of this trial was to compare postoperative discomfort, emergence delirium, and recovery time of patients who received either an LMAw or nasotracheal intubation (NTI). Patients and methods: A total of 70 children were randomly assigned to the LMAw group (n=35) or the NTI group (n=35)...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29377866/dexamethasone-as-an-adjuvant-to-femoral-nerve-block-in-children-and-adolescents-undergoing-knee-arthroscopy-a-prospective-randomized-double-blind-placebo-controlled-trial
#19
Giorgio Veneziano, David P Martin, Ralph Beltran, NʼDiris Barry, Dmitry Tumin, Candice Burrier, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND AND OBJECTIVES: Perineural dexamethasone has been demonstrated to extend postsurgical analgesia after peripheral nerve blockade in adults. The mechanism of action of dexamethasone as a regional anesthetic adjuvant is unclear as intravenous dexamethasone has been shown to have similar analgesic efficacy as perineural dexamethasone. The efficacy of perineural dexamethasone has not been previously explored in the pediatric population. METHODS: After obtaining informed consent, children (aged 10-18 years) presenting for arthroscopic knee surgery with a femoral nerve block were randomized to 1 of 3 groups: ropivacaine 0...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29377404/sedation-for-magnetic-resonance-imaging-using-propofol-with-or-without-ketamine-at-induction-in-pediatrics-a-prospective-randomized-double-blinded-study
#20
Achim Schmitz, Markus Weiss, Christian Kellenberger, Ruth O'Gorman Tuura, Richard Klaghofer, Ianina Scheer, Malek Makki, Carola Sabandal, Philipp Karl Buehler
INTRODUCTION: Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging. METHODS: Children aged from 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation were included...
March 2018: Paediatric Anaesthesia
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