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https://www.readbyqxmd.com/read/29454582/predictors-and-outcomes-of-cardiac-surgery-associated-delirium-a-single-centre-retrospective-cohort-study
#1
Daryl Jones, George Matalanis, Johan Mårtensson, Raymond Robbins, Margaret Shaw, Siven Seevanayagam, Dean Cowie, Rinaldo Bellomo
BACKGROUND: The predictors and independent outcome association of delirium after cardiac surgery are important and yet poorly characterised. METHODS: We performed a retrospective observational study of cardiac surgery patients between January 2009 and March 2016. We defined delirium using ICD-10 diagnostic codes. Multivariable analysis was conducted to find independent associations between baseline variables, delirium, and key clinical outcomes. RESULTS: We studied 2447 study patients (28...
February 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29445508/development-of-the-japanese-version-of-the-preschool-confusion-assessment-method-for-the-icu
#2
Yujiro Matsuishi, Haruhiko Hoshino, Nobutake Shimojo, Yuki Enomoto, Takahiro Kido, Subrina Jesmin, Masahiko Sumitani, Yoshiaki Inoue
Aim: Delirium is associated with various negative clinical outcomes, such as decline in cognitive ability, increased length of hospital stay, and higher mortality. For these reasons, early diagnosis of delirium is critical. Unfortunately, there are no reliable diagnostic criteria or tool of delirium for infants and preschool-aged children in Japan. The aim of the present study was to translate a new delirium assessment tool, the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU), for accurately diagnosing clinically ill infants and preschool-aged children, from English to Japanese...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29444340/antipsychotics-delirium-and-acute-respiratory-distress-syndrome-what-is-the-link
#3
Heather Torbic, Abhijit Duggal
Acute respiratory distress syndrome (ARDS) is an acute inflammatory process that impairs the ability of the lungs to oxygenate and ultimately leads to respiratory failure. Patients who develop ARDS often have prolonged and complicated hospital courses putting them at risk for intensive care unit (ICU) delirium. Patients with ICU delirium often need chemical sedation, mechanical ventilation, prolonged duration of ICU and hospital stays, long-term cognitive impairment, and increased mortality. In a patient with ARDS, ICU delirium further complicates the hospital course and increases the risk of morbidly and mortality...
February 14, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29437077/delirium-assessment-tools-for-use-in-critically-ill-adults-a-psychometric-analysis-and-systematic-review
#4
Céline Gélinas, Mélanie Bérubé, Annie Chevrier, Brenda T Pun, E Wesley Ely, Yoanna Skrobik, Juliana Barr
BACKGROUND: Delirium is highly prevalent in critically ill patients. Its detection with valid tools is crucial. OBJECTIVE: To analyze the development and psychometric properties of delirium assessment tools for critically ill adults. METHODS: Databases were searched to identify relevant studies. Inclusion criteria were English language, publication before January 2015, 30 or more patients, and patient population of critically ill adults (>18 years old)...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#5
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29428252/delirium-during-the-first-evaluation-of-children-aged-five-to-14%C3%A2-years-admitted-to-a-paediatric-critical-care-unit
#6
Eliana María Cano Londoño, Isabel Cristina Mejía Gil, Katerine Uribe Hernández, Carmenza Ricardo Ramírez, Matilde Ligia Álvarez Gómez, Ricardo Antonio Consuegra Peña, Camilo Andrés Agudelo Vélez, Susana Zuluaga Penagos, Mussatye Elorza Parra, José G Franco Vásquez
OBJECTIVES: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14 years. METHOD/DESIGN: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type...
February 7, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29427259/intraoperative-cerebral-oximetry-based-management-for-optimizing-perioperative-outcomes-a-meta-analysis-of-randomized-controlled-trials
#7
Andres Zorrilla-Vaca, Ryan Healy, Michael C Grant, Brijen Joshi, Lucia Rivera-Lara, Charles Brown, Marek A Mirski
PURPOSE: Although evidence from observational studies in a variety of clinical settings supports the utility of cerebral oximetry as a predictor of outcomes, prospective clinical trials thus far have reported conflicting results. This systematic review and meta-analysis was designed to evaluate the influence of management associated with intraoperative cerebral oximetry on postoperative outcomes. The primary outcome was postoperative cognitive dysfunction (POCD), with secondary outcomes that included postoperative delirium, length of intensive care unit (ICU) stay, and hospital length of stay (LOS)...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29423967/suvorexant-is-associated-with-a-low-incidence-of-delirium-in-critically-ill-patients-a-retrospective-cohort-study
#8
Tomoyuki Masuyama, Masamitsu Sanui, Naoto Yoshida, Yusuke Iizuka, Kunio Ogi, Satoko Yagihashi, Kanae Nagatomo, Yusuke Sasabuchi, Alan K Lefor
BACKGROUND: Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. METHODS: This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital...
February 8, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29416240/intensive-care-unit-delirium-a-wide-gap-between-actual-prevalence-and-psychiatric-referral
#9
Sandeep Grover, Siddharth Sarkar, Lakshmi Narayana Yaddanapudi, Abhishek Ghosh, Amit Desouza, Debasish Basu
Background and Aims: The study aimed to assess the rates of delirium in an Intensive Care Unit (ICU) prospectively assessed with a delirium screening instrument and confirmed through psychiatrist evaluation. In addition, the referral rate to psychiatric consultation liaison services from the same ICU was assessed through the rates of psychiatric referral over the previous 10 years. Material and Methods: In the prospective part of the study, consecutive patients aged 16 years or more admitted to the ICU of a tertiary care hospital were assessed daily for delirium using confusion assessment method for the ICU, a validated instrument that can be used for both mechanically ventilated and nonventilated patient by trained heath care personnel...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29405671/light-sedation-with-dexmedetomidine-a-practical-approach-for-the-intensivist-in-different-icu-patients
#10
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/29402358/-effect-of-early-mobilization-on-diaphragmatic-function-in-patients-with-mechanical-ventilation-a-prospective-randomized-controlled-study
#11
Shengqiang Yang, Jinggang Liu, Wenbao Yang, Jiyin Yuan, Suqiu Meng, Maoling Liang, Qibiao Shi
OBJECTIVE: To investigate the effect of early mobilization on diaphragmatic function in patients with mechanical ventilation (MV). METHODS: Sixty chronic obstructive pulmonary disease with acute exacerbation (AECOPD) patients with respiratory failure (RF) and underwent MV admitted to intensive care unit (ICU) of Huxi Affiliated Hospital of Jining Medical College from January 2016 to January 2017 were enrolled. The patients were divided into treatment group (n = 30) and control group (n = 30) by randomly number table method...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29376502/prediction-and-early-detection-of-delirium-in-the-intensive-care-unit-by-using-heart-rate-variability-and-machine-learning
#12
Jooyoung Oh, Dongrae Cho, Jaesub Park, Se Hee Na, Jongin Kim, Jaeseok Heo, Cheung Soo Shin, Jae-Jin Kim, Jin Young Park, Boreom Lee
Delirium is an important syndrome in intensive care unit (ICU), however, it is usually under-recognized during the treatment. This study was performed to investigate whether the delirious patients can be successfully distinguished from the non-delirious patients by using heart rate variability (HRV) and machine learning. Approach: Electrocardiography (ECG) data of 140 patients was acquired during daily ICU care, and HRV were analyzed. Delirium, including its type, severity, and etiologies, was evaluated daily by trained psychiatrists...
January 29, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29372070/a-feasibility-study-of-a-randomised-controlled-trial-to-examine-the-impact-of-the-abcde-bundle-on-quality-of-life-in-icu-survivors
#13
Kellie Sosnowski, Marion L Mitchell, Hayden White, Lynette Morrison, Joanne Sutton, Jessica Sharratt, Frances Lin
Background: Early rehabilitation has been found to prevent delirium and weakness that can hamper the recovery of intensive care unit (ICU) survivors. Integrated clinical practice guidelines for managing patient pain, agitation and delirium (PAD) have been developed. The Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle provides a strategy to implement PAD guidelines into everyday clinical practice. However, there is limited evidence on the effectiveness of the ABCDE bundle in the literature...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29358101/the-validity-and-reliability-of-the-arabic-version-of-the-confusion-assessment-method-for-the-intensive-care-unit-cam-icu-a-prospective-cohort-study
#14
Abeer Selim, Nahed Kandeel, Mohamed Elokl, Mohamed Shawky Khater, Ashraf Nabil Saleh, Rami Bustami, E Wesley Ely
BACKGROUND: Accurate diagnosis for Arabic speaking critically ill patients suffering from delirium is limited by the need for a valid/reliable translation of a standardized delirium instrument such as the Confusion Assessment Method for the ICU (CAM-ICU). OBJECTIVE: To determine the validity and reliability of the Arabic version of the CAM-ICU. DESIGN: A prospective cohort study design was used to conduct the current study. SETTINGS: Data collection took place in Geriatric, Emergency and Surgical intensive care units...
December 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29357776/comparison-of-lurasidone-versus-quetiapine-for-the-treatment-of-delirium-in-critically-ill-patients
#15
Marlena A Fox, Jessica L Elefritz, Brandon M Huang, Charles Hunley
OBJECTIVE: To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients. DESIGN: Prospective, observational cohort study. SETTING: Single-center community teaching hospital. PATIENTS: Forty adult intensive care unit (ICU) patients with delirium (Confusion Assessment Method in the ICU positive), tolerating enteral nutrition, and without active alcohol withdrawal or prior use of atypical antipsychotics...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29343034/-a-study-on-the-effects-and-safety-of-sequential-humidified-high-flow-nasal-cannula-oxygenation-therapy-on-the-copd-patients-after-extubation
#16
J C Zhang, F X Wu, L L Meng, C Y Zeng, Y Q Lu
Objective: To investigate and compare the effect and safety of nasal high-flow oxygen therapy (HFNCO) and noninvasive ventilation (NIV) therapy after extubation in patients with chronic obstructive pulmonary disease (COPD). Methods: All COPD patients subjected to mechanical ventilation in the Emergency Intensive Unit of the First Affiliated Hospital of Zhejiang University during January 2015 to June 2016 were included in the study. The patients were divided into two groups after extubation and HFNCO and NIV were adopted on each group respectively...
January 9, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29340154/the-impact-of-sepsis-delirium-and-psychological-distress-on-self-rated-cognitive-function-in-icu-survivors-a-prospective-cohort-study
#17
Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
Background: Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29304923/potentially-modifiable-risk-factors-for-long-term-cognitive-impairment-after-critical-illness-a-systematic-review
#18
REVIEW
Amra Sakusic, John C O'Horo, Mikhail Dziadzko, Dziadzko Volha, Rashid Ali, Tarun D Singh, Rahul Kashyap, Ann M Farrell, John D Fryer, Ronald Petersen, Ognjen Gajic, Alejandro A Rabinstein
Long-term cognitive impairment is common in survivors of critical illness. Little is known about the etiology of this serious complication. We sought to summarize current scientific knowledge about potentially modifiable risk factors during intensive care unit (ICU) treatment that may play a substantial role in the development of long-term cognitive impairment. All searches were run on October 1, 2017. The search strategy included Ovid MEDLINE, Ovid Embase, Ovid CDR, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effect, Scopus, and Web of Science, and included MeSH headings and keywords related to intensive care, critical care, and cognitive disorders...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29276990/bright-light-and-oxygen-therapies-decrease-delirium-risk-in-critically-ill-surgical-patients-by-targeting-sleep-and-acid-base-disturbances
#19
Sirimas Potharajaroen, Sookjaroen Tangwongchai, Thavatchai Tayjasanant, Thammasak Thawitsri, George Anderson, Michael Maes
This study examined the effects of bright light therapy (BLT) on the incidence of delirium in post-operative patients admitted to a surgical intensive care unit (SICU) and delineates risk and protective factors. We included 62 patients in a single-blind, randomized controlled study. The intervention group was treated with care as usual plus BLT for three consecutive days. Delirium was diagnosed by DSM-5 criteria with the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Risk factors for delirium were measured, including the APACHE II score, Insomnia Severity Index (ISI), as well as hematocrit and bicarbonate levels...
December 18, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29276297/patient-outcomes-associated-with-phenobarbital-use-with-or-without-benzodiazepines-for-alcohol-withdrawal-syndrome-a-systematic-review
#20
Drayton A Hammond, Jordan M Rowe, Adrian Wong, Tessa L Wiley, Kristen C Lee, Sandra L Kane-Gill
Purpose: Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Methods: Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using ["phenobarbital" or "barbiturate"] and ["alcohol withdrawal" or "delirium tremens."] Risk of bias was assessed using tools recommended by National Heart, Lung, and Blood Institute...
October 2017: Hospital Pharmacy
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