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ICU delirium

Nicola Vargas, Loredana Tibullo, Emanuela Landi, Giovanni Carifi, Alfonso Pirone, Antonio Pippo, Immacolata Alviggi, Renato Tizzano, Elisa Salsano, Francesco Di Grezia, Maria Vargas
Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity...
October 19, 2016: Aging Clinical and Experimental Research
Huan Mark Nguyen, Doreen Pon
OBJECTIVE: Evaluate recent clinical studies involving the use of dexmedetomidine (DEX) infusion for the treatment of delirium in the intensive care unit (ICU). METHODS: A literature search was conducted to identify peer-reviewed articles in MEDLINE (1966-June 2016) using the terms sedation, analgesic, dexmedetomidine, delirium, and critically ill adult patients. RESULTS: Two studies in the ICU setting reported the potential benefits of DEX for managing agitation during weaning from mechanical ventilation...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
Peter W Lange, Andrea B Maier
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Kimberly Giraud, Megan Pontin, Linda D Sharples, Paul Fletcher, Tim Dalgleish, Allaina Eden, David P Jenkins, Alain Vuylsteke
Introduction: Post-operative delirium remains a significant problem, particularly in the older surgical patient. Previous evidence suggests that the provision of supplementary visual feedback about ones environment via the use of a mirror may positively impact on mental status and attention (core delirium diagnostic domains). We aimed to explore whether use of an evidence-based mirrors intervention could be effective in reducing delirium and improving post-operative outcomes such as factual memory encoding of the Intensive Care Unit (ICU) environment in older cardiac surgical patients...
2016: Frontiers in Aging Neuroscience
David J Gagnon, Gabriel V Fontaine, Kathryn E Smith, Richard R Riker, Russell R Miller, Patricia A Lerwick, F L Lucas, John T Dziodzio, Kristen C Sihler, Gilles L Fraser
PURPOSE: The purpose was to describe the use of valproate therapy for agitation in critically ill patients, examine its safety, and describe its relationship with agitation and delirium. MATERIALS AND METHODS: This retrospective cohort study evaluated critically ill adults treated with valproate for agitation from December 2012 through February 2015. Information on valproate prescribing practices and safety was collected. Incidence of agitation, delirium, and concomitant psychoactive medication use was compared between valproate day 1 and valproate day 3...
September 11, 2016: Journal of Critical Care
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Makris, E Manoulakas, B Tsolaki, B Karadodas, E Zakynthinos, I Palacios Garcia, A Diaz Martin, V Sanchez Encinares, M Pachón Ibañez, J Garnacho Montero, G Labrador, T Cebrero Cangueiro, V Poulose, J Koh, J W Kam, H Yeter, A Kara, O Aktepe, A Topeli, I Tsolakoglou, G Intas, P Stergiannis, A A Kolaros, E Chalari, E Athanasiadou, A Martika, G Fildisis, V Faivre, C Mengelle, B Favier, D Payen, A Poppe, M S Winkler, E Mudersbach, J Schreiber, M L Wruck, E Schwedhelm, S Kluge, C Zöllner, T Tavladaki, A M Spanaki, H Dimitriou, E Kondili, C Choulaki, E Meleti, D Kafetzopoulos, D Georgopoulos, G Briassoulis, A García-de la Torre, M V de la Torre-Prados, T Tsvetanova-Spasova, P Nuevo-Ortega, C Rueda-Molina, A Fernández-Porcel, E Camara-Sola, L Salido-Díaz, A García-Alcántara, T Tavladaki, A M Spanaki, H Dimitriou, E Kondili, C Choulaki, D E Meleti, D Kafetzopoulos, D Georgopoulos, G Briassoulis, B Suberviola, J Riera, L Rellan, M Sanchez, J C Robles, E Lopez, R Vicente, E Miñambres, M 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Pereira, A F Cardoso, C Santos, M J Malheiro, H Castro, T Cardoso, L Karnatovskaia, K Philbrick, G Ognjen, M Clark, R Molina Montero, J Luján Varas, L Alcázar Sánchez-Elvira, C Pintado Delgado, P Villa Díaz, B Llorente Ruiz, A Pardo Guerrero, J A Cambronero Galache, R Jiménez, S Rebollo, O Alejandro, A Fernández, S Moreno, L Herrera, A Ojados, M Galindo, J Murcia, M Contreras, S Sánchez-Argente, Y Bonilla, M D Rodríguez, J M Allegue, Ö Cakin, H Parlak, H Kirca, F Mutlu, B Aydınlı, M Cengiz, A Ramazanoglu, E-J Jung, S-Y Oh, H Lee, N M Filgueiras Filho, E F Ricaldi, S S Gomes, B B Ramos, C V De Lucia, C S Ballalai, J C A Oliveira, G P Araponga, L N Veiga, C S Silva, M E Garrido, J Cebrián Domenech, A Pinos Montalvo, T Ciges Chornet, P Concha Martinez, M Piñol Ribas, R Gimeno Costa, A Castellanos Ortega, C Forbes, H Prescott, A Lal, F A Khan, E G Dela Pena, J S Dizon, P P P Perez, C M J Wong, M Muñoz Garach, O Moreno Romero, R Ramirez Puerta, F Acosta Diaz, A M Perez Bailon, A Carranza 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Yoshida, D Engelberts, G Otulakowski, B Katira, M Post, N D Ferguson, L Brochard, M B P Amato, B P Kavanagh, N Koch, W Huber, J Hoellthaler, S Mair, V Phillip, R M Schmid, A Beitz, V Baladrón, F J Redondo Calvo, D Padilla, P Villarejo, R Villazala, A S Yuste, N Bejarano, R J Steenstra, H Banierink, J Hof, I C van der Horst, M W Nijsten, M Hoekstra, K Roedl, F Sterz, T Horvatits, K Horvatits, A Drolz, H Herkner, V Fuhrmann, M Kott, K Zitta, B Brandt, C Schildhauer, G Elke, L Hummitzsch, I Frerichs, N Weiler, M Albrecht, L Rey González, D Cabestrero Alonso, A Blandino Ortiz, R de Pablo Sánchez, J Higuera Lucas, K Roedl, F Sterz, A Drolz, K Horvatits, T Horvatits, H Herkner, V Fuhrmann, T Horvatits, A Drolz, K Roedl, K Rutter, A Ferlitsch, G Fauler, M Trauner, V Fuhrmann, T Horvatits, S Pischke, L Fischer, F Thaiss, M Koch, K Bangert, V Fuhrmann, S Kluge, A W Lohse, B Nashan, M Sterneck, S Faenza, A Siniscalchi, E Pierucci, E Mancini, D Ricci, C Gemelli, A Cuoghi, S Magnani, M Atti, F Sotos, J Cánovas, A López, A Burruezo, D Torres, M E Herrera-Gutierrez, J Barrueco-Francioni, D Arias-Verdú, R Lozano-Saez, G Quesada-Garcia, G Seller-Pérez, A Figueiredo, Y Anzola, R Pereira, L Bento, D Arias-Verdú, M Lai, M Deiana, J Barrueco-Francioni, M E Herrera-Gutierrez, G Seller-Perez, K Vardas, S Ilia, A Sertedaki, E Charmadari, C A Stratakis, E Briassouli, D Goukos, K Psarra, E Botoula, S Tsagarakis, E Mageira, C Routsi, S Nanas, G Briassoulis, A Boscolo, D Bertini, E Campello, V Lucchetta, E Piasentini, C M Radu, L Manesso, P Simioni, C Ori, H Su, Y M Lam, K Willis, V Pullar, R P Hubner, J L Tsang, L García de Guadiana-Romualdo, S Rebollo-Acebes, P Esteban-Torrella, R Jiménez-Sánchez, E Jiménez-Santos, A Ortín-Freire, A Hernando-Holgado, M D Albaladejo-Otón, L Coelho, L Rabello, J Salluh, I Martin-Loeches, A Rodriguez, S Nseir, P Póvoa, E Varis, V Pettilä, M Poukkanen, S Jacob, S Karlsson, A Perner, J Takala, E Wilkman, O H M Lundberg, L Bergenzaun, J Rydén, M Rosenqvist, O Melander, M S Chew, E Rodriguez-Ruiz, R Hernández Vaquero, A Lopez Lago, J L Garcia Allut, A Estany Gestal, M A Garcia Gonzalez, Y Kishihara, H Yasuda, S Rebollo, L García de Guadiana-Romualdo, R Jimenez, P Esteban Torrella, A Fernandez, S Sanchez, A Ortin, G Li Bassi, R Guillamat Prats, A Artigas, E Aguilera, D Marti, O T Ranzani, M Rigol, L Fernandez, M Ferrer, I Martin-Loeches, A Torres, V S Lanziotti, P Póvoa, L Pulcheri, M O Ribeiro, A P Barbosa, J R Lapa E Silva, M Soares, J I F Salluh, I Palacios Garcia, A Diaz Martin, M Gil Marqués, A Puppo Moreno, A Gutierrez Pizarraya, J Pachón Diaz, M Pachón Ibañez, Y Smani, M Mc Connell, L A Zhang, R S Parker, I Banerjee, G Clermont, E Norberg, J Oras, A Cuisinier, C Maufrais, J F Payen, S Nottin, G Walther, P Bouzat, S Arib, F Bilotta, R Badenes, F Rubulotta, S Mirek, I A Crippa, B Monfort, E Stazi, A Lozano Roig, J Creteur, F S Taccone, S Magnoni, M Marando, S Pifferi, V Conte, F Ortolano, M Carbonara, G Bertani, E Scola, M Cadioli, F Triulzi, A Colombo, N Stocchetti, H B Rotzel, A Serrano Lázaro, D Aguillón Prada, M Rodriguez Guimillo, C Sanchís Piqueras, J Romero Guia, M García Simon, A Mesejo Arizmendi, A Carratalá, S El Maraghi, A Yehia, M Bakry, A Shoman, F N Backes, M M Bianchin, S R R Vieira, A de Souza, A N Backes, C Klein, M S Kalaiselvan, M K Renuka, A S Arunkumar, A Lozano, O Lheureux, R Badenes, J L Vincent, J Creteur, F S Taccone, C Gallaher, S Cattlin, S Gordon, J Picard, V Fontana, O Bond, L Nobile, J L Vincent, J Creteur, F S Taccone, S Mrozek, L Delamarre, F Capilla, T Al-Saati, O Fourcade, T Geeraerts, A M Dominguez-Berrot, M Gonzalez-Vaquero, M E Vallejo-Pascual, D Gupta, B D Ivory, M Chopra, J McCarthy, C L Felderhof, C MacNeil, F Rubulotta, P Waldauf, M Maggiorini, F Duska, R R L Fumis, J M Vieira Junior, G Amarante, A Skorko, S Sanders, J Aron, R J Kroll, C Redfearn, P Krishnan, J E Khalil, F Kovari, N Kongpolprom, V Gulia, E Lourenço, L Melão, C Duro, G Baptista, A Alves, B Arminda, M Rodrigues, A Marreiros, C Granja, J Hayward, F Baldwin, R Gray, P A Katinakis, M Stijf, M Ten Kleij, M Jansen-Frederiks, R Broek, M de Bruijne, P E Spronk, K Sinha, M Luney, K Palmer, L Keating, M Abu-Habsa, R Bahl, N Baskaralingam, A Ahmad, L Kanapeckaite, P Bhatti, S Glace, S Jeyabraba, H F Lewis, A Kostopoulos, M Raja, A West, A Ely, L M Turkoglu, P Zolfaghari, J P Baptista, M P Marques, P Martins, J Pimentel, D Gupta, Y C Su, S Villacres, M E Stone, A Parsikia, S Medar, K P O'Dea, J Porter, N Tirlapur, J M Jonathan, S Singh, M Takata, M Abu-Habsa, A Ahmad, E McWhirter, R Lyon, M L Hariz, E Azmi, J Alkhan, S Honeybul, V Movsisyan, S Petrikov, Z Marutyan, I Aliev, A Evdokimov, E Antonucci, T Merz, C Hartmann, P Pelosi, E Calzia, P Radermacher, B Nußbaum, C Hartmann, M Huber-Lang, M Gröger, P Radermacher, B Nußbaum, B Nußbaum, E Antonucci, E Calzia, P Pelosi, P Radermacher, C Hartmann, E Svoren-Jabalera, E E Davenport, P Humburg, J Knight, C J Hinds, I J Jun, W J Kim, E H Lee, G Besch, A Perrotti, M Puyraveau, L Carteron, M Baltres, E Samain, S Chocron, S Pili-Floury, E P Plata-Menchaca, J Sabater-Riera, M Estruch, E Boza, F Sbraga, J Toscana-Fernández, E Bruguera-Pellicer, J Ordoñez-Llanos, X L Pérez-Fernández, P Cavaleiro, A Tralhão, M Arrigo, J-P Lopes, M Lebrun, B Cholley, J L PerezVela, H MarinMateos, J J Jimenez Rivera, M A Alcala Llorente, B Gonzalez De Marcos, F J Gonzalez Fernandez, C Garcia Laborda, D Fernandez Zamora, J C Lopez Delgado, C Imperiali, D Berbel-Franco, M Dastis, G Moreno-Gonzalez, J Perez-Sanchez, I Romera-Peregrina, R Abellan-Lencina, A Martinez-Pascual, V Fuentes-Mila, M Gonzalez-Romero, J Górka, K Górka, T Iwaniec, M Frołow, K Polok, J Fronczek, M Kózka, J Musiał, W Szczeklik, A González Pérez, P Florez Ordoñez, A Giribet, M A Alonso Cuervo, R Alonso Cuervo, M A Rodriguez Esteban, L Iglesias Fraile, C Ponte Mittelbrum, G Muñiz Albaiceta, F Ampatzidou, M Sileli, G Kehagioglou, A Madesis, T Karaiskos, C Moursia, H Maleoglou, K Leleki, G Drossos, Z Uz, Y Ince, R Papatella, E Bulent, P Guerci, C Ince, B De Mol, V Vicka, D Gineityte, D Ringaitiene, I Norkiene, J Sipylaite, C Möller, C Fleischmann, D O Thomas-Rueddel, V Vlasakov, B Rochwerg, P Theurer, L Gattinoni, K Reinhart, C S Hartog, A González Pérez, J Zanabili Al Sibai, P Martinez Camblor, P Alvarez Fernandez, J M García Gala, J Silba Guisasola, G Muñiz Albaiceta, T Tamura, T Yatabe, I Miyajima, K Yamashita, M Yokoyama, F Ampatzidou, G Kehagioglou, E Dalampini, M Nastou, A Baddour, A Ignatiadis, T Asteri, G Drossos, K E Hathorn, S W Purtle, C M Horkan, F K Gibbons, K B Christopher, M V Viana, T A Tonietto, L A Gross, V L Costa, A L J Tavares, B O Lisboa, R B Moraes, S R Vieira, L V Viana, M J Azevedo, G D Ceniccola, R S F Pequeno, T P Holanda, V S Mendonça, W M C Araújo, L S F Carvalho, E Segaran, L Vickers, K Brinchmann, I Wignall, F Rubulotta, I De Brito-Ashurst, R Del Olmo, M J Esteban, C Vaquerizo, R Carreño, V Gálvez, G Kaminsky, B Nieto, M Fuentes, M A De la Torre, E Torres, A Alonso, C Velayos, T Saldaña, A Escribá, J Grip, R Kölegård, P Sundblad, O Rooyackers, Ben Naser, F Jaziri, A Ben Jazia, M Barghouth, O Hentati, W Skouri, M El Euch, M Mahfoudhi, S Turki, K Ben Abdelghni, Ben Abdallah, B N M Maha, J Cánovas, F Sotos, A López, M Lorente, A Burruezo, D Torres, K Polok, A Włudarczyk, J Górka, A Hałek, J Musiał, W Szczeklik, A Ben Jazia, F Jaziri, M Bargouth, M Bennasr, S Turki, K Ben Abdelghani, T Ben Abdallah, H J de Grooth, I L Geenen, J J Parienti, H M Oudemans-van Straaten, H P Shum, H S King, K C Chan, W W Yan, J Gonzalez Londoño, C Lorencio Cardenas, M Morales Pedrosa, C Murcia Gubianas, C Fuster Bertolin, N Vila Batllori, J M Sirvent, K Wykes, J Jack, P Morgan, A Mukhopadhyay, H Y Chan, Y Kowitlawakul, D Remani, C S F Leong, C J Henry, Z A Puthucheary, N Mendsaikhan, T Begzjav, G Lundeg, M Dünser, E D Valenzuela Espinoza, S P Welsh, M F Motta, E Guerra, M C L Zerpa, F Zechner, M Furche, F Berdaguer, P N Rubatto Birri, A Risso-Vazquez, A Dubin, F D Masevicius, D Greaney, A Magee, G Fitzpatrick, R G Lugo-Cob, L A Sánchez-Hurtado, P C Arvizu-Tachiquín, B C Tejeda-Huezo, A A Cano-Oviedo, J A Baltazar-Torres, M S Aydogan, T Togal, A Taha, H Z Chai, C Kam, S S Yang Razali, V Sivasamy, L Y Kuan, V Poulose, M A Lopez Morales, S Castro, T Pires, L Melão, A Krystopchuk, I Pereira, C Granja, L U Taniguchi, E M C Pires, J M Vieira, L C P Azevedo
No abstract text is available yet for this article.
September 2016: Intensive Care Medicine Experimental
Satomi Mori, Juliana Rumy Tsuchihashi Takeda, Fernanda Souza Angotti Carrara, Cibelli Rizzo Cohrs, Suely Sueko Viski Zanei, Iveth Yamaguchi Whitaker
OBJECTIVES: To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. METHOD: Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium...
July 2016: Revista da Escola de Enfermagem da U S P
Sarah Elizabeth Jolley, Marc Moss, Dale M Needham, Ellen Caldwell, Peter E Morris, Russell R Miller, Nancy Ringwood, Megan Anders, Karen K Koo, Stephanie E Gundel, Selina M Parry, Catherine L Hough
OBJECTIVE: Early mobility in mechanically ventilated patients is safe, feasible, and may improve functional outcomes. We sought to determine the prevalence and character of mobility for ICU patients with acute respiratory failure in U.S. ICUs. DESIGN: Two-day cross-sectional point prevalence study. SETTING: Forty-two ICUs across 17 Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Adult patients (≥ 18 yr old) with acute respiratory failure requiring mechanical ventilation...
September 22, 2016: Critical Care Medicine
Giovanni Mistraletti, Michele Umbrello, Stefania Anania, Elisa Andrighi, Alessandra Di Carlo, Federica Martinetti, Serena Barello, Giovanni Sabbatini, Paolo Formenti, Tommaso Maraffi, Francesco Marrazzo, Alessandra Palo, Giacomo Bellani, Riccarda Russo, Silvia Francesconi, Federico Valdambrini, Marco Cigada, Francesca Riccardi, Egidio A Moja, Gaetano Iapichino
BACKGROUND: International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. METHODS: Multicenter, randomized, before and after study...
September 20, 2016: Minerva Anestesiologica
T Saller, V V Dossow, K Hofmann-Kiefer
BACKGROUND: Delirium is a common complication in critical care. The syndrome is often underestimated due to its potentially no less dangerous course as a hypoactive delirium. Therefore, current guidelines ask for a structured, regular and routine screening in all intensive care units. If delirium is diagnosed, symptomatic therapy should be initiated promptly. OBJECTIVES: The aim of the current study was to evaluate recent German anesthetists' strategies regarding delirium care compared to the German guidelines for sedation and delirium in intensive care...
October 2016: Der Anaesthesist
Andrew C Faust, Pearl Rajan, Lyndsay A Sheperd, Carlos A Alvarez, Phyllis McCorstin, Rebecca L Doebele
BACKGROUND: Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a "lighter" depth of sedation. Among these strategies are "analgosedation" protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously infused sedatives such as propofol or midazolam. We hypothesized that using an analgosedation protocol would result in a shorter duration of mechanical ventilation than a protocol with greater emphasis on IV sedatives METHODS: : We conducted a retrospective study comparing the duration of mechanical ventilation before and after implementation of an analgosedation protocol in a 24-bed medical ICU...
October 2016: Anesthesia and Analgesia
Alessandro Putzu, Alessandro Belletti
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
Danine Sullinger, Alexander Gilmer, Lesly Jurado, Lisa Hall Zimmerman, Joshua Steelman, Ann Gallagher, Tiffany Dupre, Elizabeth Acquista
BACKGROUND: Delirium in the critically ill is associated with increased mortality, length of stay (LOS), and prolonged cognitive dysfunction. Existing guidelines provide no recommendation for use of combination nonpharmacological and pharmacological prevention protocols or use of antipsychotic medications for the prevention or treatment of delirium. OBJECTIVE: This study evaluated the impact of implementing a delirium treatment protocol on the number of delirium-free days experienced by acutely delirious patients in the surgical trauma intensive care unit (STICU)...
September 14, 2016: Annals of Pharmacotherapy
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane English
BACKGROUND: Sedation is an important consideration in the care of the neurocritically ill patient. It provides anxiety and relief, facilitates procedures and nursing tasks, and minimizes intolerance of mechanical ventilation. Alpha-2 agonists such as dexmedetomidine and clonidine have been shown to be an effective alternative in the general critical care population by reducing duration of mechanical ventilation and length of stay in the intensive care unit (ICU), as compared to traditional sedative agents such as propofol or benzodiazepines...
2016: Systematic Reviews
L D Burry, B Hutton, M Guenette, D Williamson, S Mehta, I Egerod, S Kanji, N K Adhikari, D Moher, C M Martin, L Rose
BACKGROUND: Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used...
2016: Systematic Reviews
P Nydahl, R Dubb, S Filipovic, C Hermes, F Jüttner, A Kaltwasser, S Klarmann, H Mende, S Nessizius, C Rottensteiner
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters...
September 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Natalie R Heriot, Michele R Levinson, Amber C Mills, Thinn Thinn Khine, Anthea L Gellie, Gaya Sritharan
OBJECTIVE: To determine the incidence of delirium in elderly intensive care patients and to compare incidence using two retrospective chart-based diagnostic methods and a hospital reporting measure (ICD-10). DESIGN: Retrospective study. SETTING: An ICU in a large metropolitan private hospital in Melbourne, Australia. PATIENTS: English-speaking participants (n=348) 80+ years, admitted to ICU for >24 hours. MEASUREMENTS AND MAIN RESULTS: Medical files of ICU patients admitted October 2009-October 2012 were retrospectively assessed for delirium using the Inouye chart review method, DSM-IV diagnostic criteria and ICD-10 coding data...
September 3, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Marie Oxenbøll-Collet, Ingrid Egerod, Vibeke Christensen, Jeannette Jensen, Thordis Thomsen
BACKGROUND: Delirium in the intensive care unit (ICU) has received more attention in the past decade. Early detection, prevention and treatment of delirium are important, and the most commonly used tool for delirium assessment is the Confusion Assessment Method for the ICU (CAM-ICU). AIM: The aim of this study was to identify nurses' and physicians' perceived professional barriers to using the CAM-ICU in Danish ICUs. METHODS: This study uses a qualitative explorative multicentre design using focus groups and a semi-structured interview guide...
September 5, 2016: Nursing in Critical Care
Catharina E van Ewijk, Gabriel E Jacobs, Armand R J Girbes
BACKGROUND: Delirium is a frequently occurring syndrome in patients admitted to the intensive care unit (ICU) or medium care unit (MCU), yet the pathophysiology remains poorly understood. An excess of central serotonin can lead to an altered mental status, associated with autonomic hyperactivity, and neuromuscular excitation. Drugs with serotonergic properties are frequently and for prolonged periods administered to ICU/MCU patients. Therefore, central serotonergic toxicity may constitute a predisposing, contributing or precipitating factor in the emergence of delirium...
December 2016: Annals of Intensive Care
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