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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/29603815/the-relationship-of-delirium-and-risk-factors-in-cardiology-intensive-care-unit-patients-with-the-nursing-workload
#6
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/29602189/e-screening-revolution-a-novel-approach-to-developing-a-delirium-screening-tool-in-the-intensive-care-unit
#7
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/29595562/effect-of-administration-of-ramelteon-a-melatonin-receptor-agonist-on-the-duration-of-stay-in-the-icu-a-single-center-randomized-placebo-controlled-trial
#8
Mitsuaki Nishikimi, Atsushi Numaguchi, Kunihiko Takahashi, Yasuhiro Miyagawa, Kota Matsui, Michiko Higashi, Go Makishi, Shigeyuki Matsui, Naoyuki Matsuda
OBJECTIVES: Occurrence of delirium in the ICU is associated with a longer stay in the ICU. To examine whether the use of ramelteon, a melatonin agonist, can prevent delirium and shorten the duration of ICU stay of critically ill patients. DESIGN: A single-center, triple-blinded, randomized placebo-controlled trial. SETTING: ICU of an academic hospital. PATIENTS: Eligible patients were ICU patients who could take medicines orally or through a nasogastric tube during the first 48 hours of admission...
March 27, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29580965/designing-a-nurse-delivered-delirium-bundle-what-intensive-care-unit-staff-survivors-and-their-families-think
#9
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
#10
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
#11
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
#12
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/29545081/effect-of-organisational-factors-on-the-variation-in-incidence-of-delirium-in-intensive-care-unit-patients-a-systematic-review-and-meta-regression-analysis
#13
REVIEW
Paul Rood, Getty Huisman-de Waal, Hester Vermeulen, Lisette Schoonhoven, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium occurs frequently in intensive care unit (ICU) patients and is associated with numerous deleterious outcomes. There is a large variation in reported delirium occurrence rates, ranging from 4% to 89%. Apart from patient and treatment-related factors, organisational factors could influence delirium incidence, but this is currently unknown. OBJECTIVE: To systematically review delirium incidence and determine whether or not organisational factors may contribute to the observed delirium incidence in adult ICU patients...
March 12, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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
#14
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
The findings can facilitate earlier recognition and prevention of pediatric delirium. ABSTRACT: 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...
March 14, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29537480/screening-for-delirium-with-the-intensive-care-delirium-screening-checklist-icdsc-a-re-evaluation-of-the-threshold-for-delirium
#15
Soenke Boettger, David Garcia Nuñez, Rafael Meyer, Andre Richter, Alain Rudiger, Maria Schubert, Josef Jenewein
BACKGROUND: With its high incidence and subsequent adverse consequences in the intensive care setting, several instruments have been developed to screen for and detect delirium. One of the more commonly used is the Intensive Care Delirium Screening Checklist (ICDSC); however, the optimal cut-off score indicating delirium has been debated. METHODS: In this prospective cohort study, the ICDSC threshold for delirium set at ≥3, ≥4, or ≥5 was compared with the DSM-IV-TR-determined diagnosis of delirium (used as standard), and with the Confusion Assessment Method for the ICU (CAM-ICU), with respect to their concurrent validity...
March 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29534406/-predictive-value-of-serum-s100b-levels-in-patients-with-multiple-trauma-combined-delirium-for-their-outcome-at-intensive-care-unit-discharge
#16
J Liu, Y Li, Y Cai, Z C Jin
Objective: To investigate the predictive value of elevated serum S100B level in patients with multiple traumas combined delirium for the clinical prognosis prior to intensive care unit (ICU) discharge. Methods: One hundred seventy-nine patients with multiple traumas diagnosed as delirium after admission over 48 hours to the Department of Critical Care Medicine, People's Hospital Affiliated to Jiangsu University from January 2013 to December 2016 were divided into two groups according to the level of serum S100B measured prior to the ICU discharge: high S100B group (≥0...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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
#17
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/29523900/relationships-between-markers-of-neurologic-and-endothelial-injury-during-critical-illness-and-long-term-cognitive-impairment-and-disability
#18
Christopher G Hughes, Mayur B Patel, Nathan E Brummel, Jennifer L Thompson, J Brennan McNeil, Pratik P Pandharipande, James C Jackson, Rameela Chandrasekhar, Lorraine B Ware, E Wesley Ely, Timothy D Girard
PURPOSE: Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge. METHODS: We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission...
March 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29521716/interprofessional-care-and-teamwork-in-the-icu
#19
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29511871/risk-factors-of-postoperative-delirium-in-the-intensive-care-unit-after-liver-transplantation
#20
Hannah Lee, Seung-Young Oh, Je Hyuk Yu, Jeongsoo Kim, Sehee Yoon, Ho Geol Ryu
BACKGROUND: Postoperative delirium after liver transplantation is relatively common, especially due to preexisting conditions such as hepatic encephalopathy. Most studies of delirium after liver transplantation were based on ICU practices using deep hypnosedation. Therefore, risk factors and consequences of postoperative delirium after liver transplantation were evaluated in the light sedation era. METHODS: A total of 253 liver transplantation patients were evaluated for postoperative delirium...
March 6, 2018: World Journal of Surgery
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