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ICU delirium

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https://www.readbyqxmd.com/read/28725854/improving-the-patient-experience-by-implementing-an-icu-diary-for-those-at-risk-of-post-intensive-care-syndrome
#1
K Taylor A Blair, Sarah D Eccleston, Hannah M Binder, Mary S McCarthy
The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS) are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay...
March 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#2
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#3
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28710219/comparison-of-propofol-and-dexmedetomidine-infused-overnight-to-treat-hyperactive-and-mixed-icu-delirium-a-protocol-for-the-basel-prodex-clinical-trial
#4
Alexa Hollinger, Katrin Ledergerber, Stefanie von Felten, Raoul Sutter, Stephan Rüegg, Lukas Gantner, Sibylle Zimmermann, Andrea Blum, Luzius A Steiner, Stephan Marsch, Martin Siegemund
BACKGROUND/OBJECTIVES: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population. It was first described more than half a century ago, where it was already discovered as a state that might come along with serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality. However, in most cases, there is still lack of proof for causal relationship. Its presence frequently remains unrecognised due to suggested predominance of the hypoactive form...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28703024/safety-and-effectiveness-of-physostigmine-a-10-year-retrospective-review
#5
Ann M Arens, Krishna Shah, Suad Al-Abri, Kent R Olson, Tom Kearney
BACKGROUND: Physostigmine has long been recognized as an antidote to reverse anticholinergic delirium. However, its effectiveness, safety profile, and dosing have been disputed. OBJECTIVES: To describe effectiveness, adverse events, and dosing associated with the use of physostigmine to reverse anticholinergic delirium. METHODS: A retrospective cohort study of hospitalized patients reported to a regional poison center system between 2003 and 2012 who received physostigmine to reverse an anticholinergic toxidrome...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28697802/outcomes-of-subsyndromal-delirium-in-icu-a-systematic-review-and-meta-analysis
#6
Rodrigo B Serafim, Marcio Soares, Fernando A Bozza, José R Lapa E Silva, Felipe Dal-Pizzol, Maria Carolina Paulino, Pedro Povoa, Jorge I F Salluh
BACKGROUND: Subsyndromal delirium (SSD) is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit (ICU) remains unclear. METHODS: We performed a systematic search in PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO, with no language restrictions, up to 1 October 2016 to identify publications that evaluated SSD in ICU patients...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28697572/delayed-recall-and-working-memory-mmse-domains-predict-delirium-following-cardiac-surgery
#7
Catherine C Price, Cynthia Garvan, Loren Hizel, Marcos G Lopez, Frederic T Billings
BACKGROUND: Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. OBJECTIVE: Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. METHODS: Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery...
July 4, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28692620/delirium-in-the-icu-what-about-the-floor
#8
Anthony Cahill, Christopher Pearcy, Vaidehi Agrawal, Phillip Sladek, Michael S Truitt
Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium in patients admitted to the trauma surgeon (TS) in non-critical care areas (NCCAs). Patients 18 years or older admitted to any TS in the designated NCCA were evaluated and consented for participation over a 3-month period. Participants were screened with the Confusion Assessment Method (CAM) every 12 hr...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28689992/characteristics-of-palliative-care-consultation-at-an-academic-level-one-trauma-center
#9
Emily B Rivet, Paula Ferrada, Tara Albrecht, J Brian Cassel, Beth Broering, Danielle Noreika, Egidio Del Fabbro
BACKGROUND: The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. METHODS: A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. RESULTS: The palliative care team evaluated 82 patients with a median age of 60 years...
June 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28677160/risk-factors-for-the-incidence-of-delirium-in-cerebrovascular-patients-in-a-neurosurgery-intensive-care-unit-icu-a-prospective-study
#10
Jun Wang, Yuanyuan Ji, Ning Wang, Wenjin Chen, Yuehong Bao, Qinpu Qin, Qian Xiao, Shulan Li
AIMS AND OBJECTIVES: To explore the incidence of delirium in cerebrovascular patients admitted in our Neurosurgery Intensive Care Unit (NICU) and analyze the risk factors leading to delirium. BACKGROUND: Delirium is one of the most common mental disorders in general hospitals, but the incidence of different kinds of diseases and studies varies. Cerebrovascular patients in our NICU are high-risk groups for delirium; identifying risk factors for delirium and taking early interventions are crucial for patient prognosis...
July 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28671901/effectiveness-and-safety-of-an-extended-icu-visitation-model-for-delirium-prevention-a-before-and-after-study
#11
Regis Goulart Rosa, Tulio Frederico Tonietto, Daiana Barbosa da Silva, Franciele Aparecida Gutierres, Aline Maria Ascoli, Laura Cordeiro Madeira, William Rutzen, Maicon Falavigna, Caroline Cabral Robinson, Jorge Ibrain Salluh, Alexandre Biasi Cavalcanti, Luciano Cesar Azevedo, Rafael Viegas Cremonese, Tarissa Ribeiro Haack, Cláudia Severgnini Eugênio, Aline Dornelles, Marina Bessel, José Mario Meira Teles, Yoanna Skrobik, Cassiano Teixeira
OBJECTIVES: To evaluate the effect of an extended visitation model compared with a restricted visitation model on the occurrence of delirium among ICU patients. DESIGN: Prospective single-center before and after study. SETTING: Thirty-one-bed medical-surgical ICU. PATIENTS: All patients greater than or equal to 18 years old with expected length of stay greater than or equal to 24 hours consecutively admitted to the ICU from May 2015 to November 2015...
June 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28668768/low-brain-tissue-oxygenation-contributes-to-the-development-of-delirium-in-critically-ill-patients-a-prospective-observational-study
#12
Michael D Wood, David M Maslove, John G Muscedere, Andrew G Day, J Gordon Boyd
PURPOSE: To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. MATERIALS AND METHODS: Adult patients admitted to the ICU within the previous 24h were considered eligible for enrollment if they required mechanical ventilation, and/or vasopressor support. BtO2 was measured using near-infrared spectroscopy, for 24h after enrollment...
June 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28652635/-risk-factors-for-delirium-in-intensive-care-unit-br-in-liver-transplant-patients
#13
Filippo Binda, Alessandro Galazzi, Alessandra Brambilla, Ileana Adamini, Dario Laquintana
. Risk factors for delirium in intensive care unit in liver transplant patients. INTRODUCTION: Delirium is a disorder of the state of consciousness characterized by acute onset and temporal variability of cognitive abilities. It is frequent in intensive care unit (ICU) and it is associated with worst outcomes. AIM: To identify risk factors for the development of delirium in patients in intensive care unit (ICU) after orthotopic liver transplantation (OLTx). METHODS: Observational retrospective study on all the patients undergoing OLTx between January 2014 and December 2015...
April 2017: Assistenza Infermieristica e Ricerca: AIR
https://www.readbyqxmd.com/read/28651508/quality-sleep-using-earplugs-in-the-intensive-care-unit-the-quiet-pilot-randomised-controlled-trial
#14
Edward Litton, Rosalind Elliott, Janet Ferrier, Steven A R Webb
OBJECTIVE: To assess the feasibility of a definitive, randomised controlled trial of earplugs as a noise-abatement strategy to improve sleep and reduce delirium in patients admitted to the intensive care unit. DESIGN AND SETTING: An open-label trial of 40 patients randomised in a 1:1 ratio to receive earplugs in addition to standard care, or standard care alone, conducted in a 10-bed ICU of a large, private hospital in Perth, Western Australia. PARTICIPANTS AND INTERVENTION: Patients were eligible for participation if they were expected to be undergoing mechanical ventilation (MV) on admission to the ICU...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28622167/statin-and-its-association-with-delirium-in-the-medical-icu
#15
Jeffrey F Mather, John P Corradi, Christine Waszynski, Adam Noyes, Yinghui Duan, James Grady, Robert Dicks
OBJECTIVES: To examine the association between statin use and the risk of delirium in hospitalized patients with an admission to the medical ICU. DESIGN: Retrospective propensity-matched cohort analysis with accrual from September 1, 2012, to September 30, 2015. SETTING: Hartford Hospital, Hartford, CT. PATIENTS: An initial population of patients with an admission to a medical ICU totaling 10,216 visits were screened for delirium by means of the Confusion Assessment Method...
June 15, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#16
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28608136/early-impairment-of-intracranial-conduction-time-predicts-mortality-in-deeply-sedated-critically-ill-patients-a-prospective-observational-pilot-study
#17
Eric Azabou, Benjamin Rohaut, Nicholas Heming, Eric Magalhaes, Régine Morizot-Koutlidis, Stanislas Kandelman, Jeremy Allary, Guy Moneger, Andrea Polito, Virginie Maxime, Djillali Annane, Frederic Lofaso, Fabrice Chrétien, Jean Mantz, Raphael Porcher, Tarek Sharshar
BACKGROUND: Somatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected. In this prospective observational bi-center pilot study, we investigated whether early impairment of SSEP's ICCT and/or BAEP's IPCT could predict in-ICU mortality or altered mental status (AMS), in deeply sedated critically ill patients...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28606450/delirium-prevention-in-critically-ill-adults-through-an-automated-reorientation-intervention-a-pilot-randomized-controlled-trial
#18
Cindy L Munro, Paula Cairns, Ming Ji, Karel Calero, W McDowell Anderson, Zhan Liang
OBJECTIVES: Explore the effect of an automated reorientation intervention on ICU delirium in a prospective randomized controlled trial. BACKGROUND: Delirium is common in ICU patients, and negatively affects outcomes. Few prevention strategies have been tested. METHODS: Thirty ICU patients were randomized to 3 groups. Ten received hourly recorded messages in a family member's voice during waking hours over 3 ICU days, 10 received the same messages in a non-family voice, and 10 (control) did not receive any automated reorientation messages...
July 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28595082/a-retrospective-analysis-of-the-effectiveness-of-antipsychotics-in-the-treatment-of-icu-delirium
#19
Cory B Weaver, Sandra L Kane-Gill, Scott R Gunn, Levent Kirisci, Pamela L Smithburger
PURPOSE: Conflicting data exists on the efficacy of antipsychotics for treatment of intensive care unit (ICU) delirium. The purpose of this study was to compare time to delirium resolution for ICU patients who were managed with and without antipsychotics. MATERIALS AND METHODS: This retrospective cohort evaluation included patients admitted to 12 ICUs at 5 sites over 5 weeks diagnosed with delirium. The primary outcome was time to delirium resolution. Secondary outcomes included ICU length of stay (LOS), mortality, discharge disposition and delirium redevelopment...
June 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28594681/delirium-and-benzodiazepines-associated-with-prolonged-icu-stay-in-critically-ill-infants-and-young-children
#20
Heidi A B Smith, Maalobeeka Gangopadhyay, Christina M Goben, Natalie L Jacobowski, Mary Hamilton Chestnut, Jennifer L Thompson, Rameela Chandrasekhar, Stacey R Williams, Katherine Griffith, E Wesley Ely, D Catherine Fuchs, Pratik P Pandharipande
OBJECTIVES: Delirium is prevalent among critically ill children, yet associated outcomes and modifiable risk factors are not well defined. The objective of this study was to determine associations between pediatric delirium and modifiable risk factors such as benzodiazepine exposure and short-term outcomes. DESIGN: Secondary analysis of collected data from the prospective validation study of the Preschool Confusion Assessment Method for the ICU. SETTING: Tertiary-level PICU...
June 7, 2017: Critical Care Medicine
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