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ICU delirium

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https://www.readbyqxmd.com/read/28323290/incidence-and-risk-factors-for-delirium-development-in-icu-patients-a-prospective-observational-study
#1
Marcela Kanova, Peter Sklienka, Roman Kula, Michal Burda, Jana Janoutova
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period...
March 14, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28322337/sedation-of-mechanically-ventilated-adults-in-intensive-care-unit-a-network-meta-analysis
#2
Zhongheng Zhang, Kun Chen, Hongying Ni, Xiaoling Zhang, Haozhe Fan
Sedatives are commonly used for mechanically ventilated patients in intensive care units (ICU). However, a variety of sedatives are available and their efficacy and safety have been compared in numerous trials with inconsistent results. To resolve uncertainties regarding usefulness of these sedatives, we performed a systematic review and network meta-analysis. Randomized controlled trials comparing sedatives in mechanically ventilated ICU patients were included. Graph-theoretical methods were employed for network meta-analysis...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28314081/delirium-after-lung-transplantation-association-with-recipient-characteristics-hospital-resource-utilization-and-mortality
#3
Yelizaveta Sher, Joshua Mooney, Gundeep Dhillon, Roy Lee, José R Maldonado
BACKGROUND: Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. METHODS: The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS and one-year mortality...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#4
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28288026/delirium-and-mortality-in-critically-ill-children-epidemiology-and-outcomes-of-pediatric-delirium
#5
Chani Traube, Gabrielle Silver, Linda M Gerber, Savneet Kaur, Elizabeth A Mauer, Abigail Kerson, Christine Joyce, Bruce M Greenwald
OBJECTIVES: Delirium occurs frequently in adults and is an independent predictor of mortality. However, the epidemiology and outcomes of pediatric delirium are not well-characterized. The primary objectives of this study were to describe the frequency of delirium in critically ill children, its duration, associated risk factors, and effect on in-hospital outcomes, including mortality. Secondary objectives included determination of delirium subtype, and effect of delirium on duration of mechanical ventilation, and length of hospital stay...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28275978/infrared-pupillometry-helps-to-detect-and-predict-delirium-in-the-post-anesthesia-care-unit
#6
Eric Yang, Matthias Kreuzer, September Hesse, Paran Davari, Simon C Lee, Paul S García
This study evaluates the capability of pupillary parameters to detect and predict delirium in the post-anesthesia care unit (PACU-D) following general anesthesia. PACU-D may complicate and prolong the patient's postoperative course, consequently increasing hospital costs. After institutional approval, 47 patients undergoing surgical interventions with general anesthesia were included in the study. We measured the pupillary reflexes at signing of informed consent, during surgery 20 min after intubation and when the primary inhaled anesthetic was turned off, and 15 and 45 min after PACU admittance and upon discharge from the PACU...
March 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28266937/occurrence-predictors-and-prognosis-of-alcohol-withdrawal-syndrome-and-delirium-tremens-following-traumatic-injury
#7
Kristin Salottolo, Emmett McGuire, Charles W Mains, Erika C van Doorn, David Bar-Or
OBJECTIVES: We sought to determine occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens in patients with traumatic injury. DESIGN: Retrospective multicenter cohort study. SETTING: Three U.S. trauma centers. PATIENTS: Twenty-eight thousand one hundred one trauma patients admitted from 2010-2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Measures included occurrence of alcohol withdrawal syndrome and delirium tremens, injury characteristics, risk factors for alcohol withdrawal syndrome, clinical outcomes, pharmacologic treatment for alcohol withdrawal syndrome, and Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scores...
March 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28263192/the-confusion-assessment-method-for-the-icu-7-delirium-severity-scale-a-novel-delirium-severity-instrument-for-use-in-the-icu
#8
Babar A Khan, Anthony J Perkins, Sujuan Gao, Siu L Hui, Noll L Campbell, Mark O Farber, Linda L Chlan, Malaz A Boustani
OBJECTIVES: Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments are difficult to complete in critically ill patients. We designed our study to assess the reliability and validity of a new ICU delirium severity tool, the Confusion Assessment Method for the ICU-7 delirium severity scale. DESIGN: Observational cohort study...
March 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28254205/a-family-intervention-to-reduce-delirium-in-hospitalised-icu-patients-a-feasibility-randomised-controlled-trial
#9
Marion L Mitchell, Susanne Kean, Janice E Rattray, Alastair M Hull, Chelsea Davis, Jenny E Murfield, Leanne M Aitken
BACKGROUND: Family members could play an important role in preventing and reducing the development of delirium in Intensive Care Units (ICU) patients. This study sought to assess the feasibility of design and recruitment, and acceptability for family members and nurses of a family delivered intervention to reduce delirium in ICU patients. METHOD: A single centre randomised controlled trial in an Australian medical/surgical ICU was conducted. Sixty-one family members were randomised (29 in intervention and 32 in non-intervention group)...
February 26, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#10
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#11
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28243074/delirium-in-405-articles-of-medical-non-surgical-or-icu-inpatients-unproven-speed-of-onset-and-recovery
#12
Paul Jay Regal
PURPOSE: There is agreement in the medical literature that delirium is of sudden or rapid onset. Although the speed of recovery cannot be used for initial diagnosis, recovery speed provides a test of diagnostic criteria. The aim of this study was to determine whether articles on delirium among medical inpatients proved sudden onset and rapid recovery. METHODS: The literature was searched for studies with at least 50 patients on medical or geriatric wards. Excluded were postoperative, critical care, and nursing home studies...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28243012/delirium-in-the-intensive-care-unit
#13
REVIEW
Suresh Arumugam, Ayman El-Menyar, Ammar Al-Hassani, Gustav Strandvik, Mohammad Asim, Ahammed Mekkodithal, Insolvisagan Mudali, Hassan Al-Thani
Delirium is characterized by impaired cognition with nonspecific manifestations. In critically ill patients, it may develop secondary to multiple precipitating or predisposing causes. Although it can be a transient and reversible syndrome, its occurrence in Intensive Care Unit (ICU) patients may be associated with long-term cognitive dysfunction. This condition is often under-recognized by treating physicians, leading to inappropriate management. For appropriate management of delirium, early identification and risk factor assessment are key factors...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28239475/long-term-cognitive-outcomes-among-unselected-ventilated-and-non-ventilated-icu-patients
#14
José Raimundo A de Azevedo, Widlani Sousa Montenegro, Djane Pereira Rodrigues, Suellen C de C Souza, Vanessa F S Araujo, Margareth Pereira de Paula, Patricia H C P Prazeres, Adenilde da Luz Leitão, Adriana V N Mendonça
BACKGROUND: Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brain dysfunction that is common during critical illness has been shown to be associated with long-term cognitive dysfunction. The aim of this prospective cohort study was to estimate the prevalence and severity of cognitive dysfunction in an unselected population of medical and surgical ICU patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#15
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28219810/continuous-electroencephalography-in-a-mixed-non-neurological-intensive-care-population-an-observational-study
#16
Patrick Schramm, Judyta Luczak, Kristin Engelhard, Jasmin El Shazly, Martin Juenemann, Marlene Tschernatsch
PURPOSE: Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. MATERIALS AND METHODS: The study analyzed the feasibility of cEEG, assessed the interpretable cEEG time, importance of automatic seizure detection, the incidence of seizures, the predominant background EEG activity, incidence of delirium and mortality...
February 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28214083/the-effect-of-nonpharmacological-training-on-delirium-identification-and-intervention-strategies-of-intensive-care-nurses
#17
Ayşegül Öztürk Birge, Hatice Tel Aydin
OBJECTIVE: This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. METHOD: This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms...
February 14, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28210771/factors-influencing-physical-activity-and-rehabilitation-in-survivors-of-critical-illness-a-systematic-review-of-quantitative-and-qualitative-studies
#18
REVIEW
Selina M Parry, Laura D Knight, Bronwen Connolly, Claire Baldwin, Zudin Puthucheary, Peter Morris, Jessica Mortimore, Nicholas Hart, Linda Denehy, Catherine L Granger
PURPOSE: To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. METHODS: Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included...
February 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28190446/prognosis-of-neurologic-complications-in-critical-illness
#19
M Van Der Jagt, E J O Kompanje
Neurologic complications of critical illness require extensive clinical and neurophysiologic evaluation to establish a reliable prognosis. Many sequelae of intensive care unit (ICU) treatment, such as delirium and ICU-acquired weakness, although highly associated with adverse outcomes, are less suitable for prognostication, but should rather prompt clinicians to seek previously unnoticed persisting underlying illnesses. Prognostication can be confounded by drug administration particularly because its clearance is abnormal in critical illness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#20
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
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