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https://www.readbyqxmd.com/read/29043462/an-experimental-model-to-measure-the-ability-of-headphones-with-active-noise-control-to-reduce-patient-s-exposure-to-noise-in-an-intensive-care-unit
#1
Stuart Gallacher, Doyo Enki, Sian Stevens, Mark J Bennett
BACKGROUND: Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient's exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment. METHODS: Sound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU...
October 17, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29042333/postoperative-intravenous-acetaminophen-for-craniotomy-patients-a-randomized-controlled-trial
#2
Steven Greenberg, Glenn S Murphy, Michael J Avram, Torin Shear, Jessica Benson, Kruti N Parikh, Aashka Patel, Rebecca Newmark, Vimal Patel, Julian Bailes, Joseph W Szokol
OBJECTIVE: To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared to those receiving placebo (normal saline). METHODS: One hundred forty patients undergoing any craniotomy were randomly assigned to receive either 1g of IV acetaminophen or placebo upon surgical closure, and every six hours thereafter, up to 18 hours postoperatively. Analgesic requirements for the first 24 hours postoperatively were recorded...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29040201/don-t-call-me-crazy-delirium-occurs-outside-of-the-icu
#3
Anthony Cahill, Christopher Pearcy, Khalid Almahmoud, Vaidehi Agrawal, Usha Mani, Phillip Sladek, Michael S Truitt
INTRODUCTION: Delirium has been well studied among patients in the Intensive Care Unit (ICU); however, data beyond the ICU is limited. The purpose of this study is to prospectively evaluate the incidence and associated risk factors for delirium in non-critical care areas (NCCA). METHODS: After IRB approval, a prospective cohort study was conducted at our urban Level I Trauma Center from December 2015 to February 2016. All patients admitted to the designated study area by a trauma surgeon were included...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29035732/development-and-validation-of-an-automated-delirium-risk-assessment-system-auto-delras-implemented-in-the-electronic-health-record-system
#4
Kyoung-Ja Moon, Yinji Jin, Taixian Jin, Sun-Mi Lee
BACKGROUND: A key component of the delirium management is prevention and early detection. OBJECTIVE: To develop an automated delirium risk assessment system (Auto-DelRAS) that automatically alerts health care providers of an intensive care unit (ICU) patient's delirium risk based only on data collected in an electronic health record (EHR) system, and to evaluate the clinical validity of this system. DESIGN: Cohort and system development designs were used...
September 23, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29028717/comparing-the-icu-7-to-the-delirium-rating-scale
#5
Paul Jay Regal
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29026932/-protocol-based-mobilization-on-intensive-care-units-design-of-a%C3%A2-cluster-randomized-pilot-study
#6
REVIEW
P Nydahl, A Diers, U Günther, B Haastert, S Hesse, C Kerschensteiner, S Klarmann, S Köpke
BACKGROUND: Despite convincing evidence for early mobilization of patients on intensive care units (ICU), implementation in practice is limited. Protocols for early mobilization, including in- and exclusion criteria, assessments, safety criteria, and step schemes may increase the rate of implementation and mobilization. HYPOTHESIS: Patients (population) on ICUs with a protocol for early mobilization (intervention), compared to patients on ICUs without protocol (control), will be more frequently mobilized (outcome)...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28991949/post-intensive-care-unit-psychiatric-comorbidity-and-quality-of-life
#7
Sophia Wang, Chris Mosher, Anthony J Perkins, Sujuan Gao, Sue Lasiter, Sikandar Khan, Malaz Boustani, Babar Khan
The prevalence of psychiatric symptoms ranges from 17% to 44% in intensive care unit (ICU) survivors. The relationship between the comorbidity of psychiatric symptoms and quality of life (QoL) in ICU survivors has not been carefully examined. This study examined the relationship between psychiatric comorbidities and QoL in 58 survivors of ICU delirium. Patients completed 3 psychiatric screens at 3 months after discharge from the hospital, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7) questionnaire for anxiety, and the Post-Traumatic Stress Syndrome (PTSS- 10) questionnaire for posttraumatic stress disorder...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28978488/icu-team-composition-and-its-association-with-abcde-implementation-in-a-quality-collaborative
#8
Deena Kelly Costa, Thomas S Valley, Melissa A Miller, Milisa Manojlovich, Sam R Watson, Phyllis McLellan, Corine Pope, Robert C Hyzy, Theodore J Iwashyna
PURPOSE: Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. MATERIALS & METHODS: We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility...
September 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28973626/delirium-in-older-persons-advances-in-diagnosis-and-treatment
#9
REVIEW
Esther S Oh, Tamara G Fong, Tammy T Hshieh, Sharon K Inouye
Importance: Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effects with substantial health care costs. Objective: To summarize the current state of the art in diagnosis and treatment of delirium and to highlight critical areas for future research to advance the field...
September 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28953621/perceptions-attitudes-and-current-practices-regards-delirium-in-china-a-survey-of-917-critical-care-nurses-and-physicians-in-china
#10
Jinyan Xing, Yunbo Sun, Yaqi Jie, Zhiyong Yuan, Wenjuan Liu
The purpose of this study is to assess the knowledge, attitudes, and managements regarding delirium of intensive care nurses and physicans, and to assess the perceived barriers related to intensive care unit (ICU) delirium monitoring in China. A descriptive survey was distributed to 1156 critical care nurses and physicians from 74 tertiary and secondary hospitals across Shandong province, China. The overall response rate was 86.18% (n = 917). The majority of respondents (88%) believed that deirium was associated with prolonged mechanical ventilation, and 79...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28947274/post-operative-delirium-is-associated-with-increased-5-year-mortality
#11
Eliza E Moskowitz, Douglas M Overbey, Teresa S Jones, Edward L Jones, Todd R Arcomano, John T Moore, Thomas N Robinson
BACKGROUND: Post-operative delirium is associated with increased short term morbidity and mortality. Limited data exists on long term outcomes for older adults with postoperative delirium. We hypothesize that postoperative delirium is associated with increased 5-year mortality. METHODS: Patients ≥50 years undergoing elective operations with planned intensive care unit (ICU) admissions were prospectively enrolled. The Confusion Assessment Method ICU (CAM-ICU) was used to diagnose delirium...
September 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28944590/effect-of-the-use-of-earplugs-and-eye-mask-on-the-quality-of-sleep-in-intensive-care-patients-a-systematic-review
#12
Hana Locihová, Karel Axmann, Hana Padyšáková, Jakub Fejfar
Intensive care unit (ICU) environment has a very strong and unavoidable negative impact on patients' sleep. Sleep deprivation in ICU patients has been already studied and negative effects on their outcome (prolonged ICU stay, decreased recovery) and complication rates (incidence of delirium, neuropsychological sequels of critical illness) discussed. Several interventions potentially improving the sleep disturbance in ICU (sleep-promotion strategies) have been assumed and tested for clinical practice. We present a review of recent literature focused on chosen types of non-pharmacological interventions (earplugs and eye mask) analysing their effect on sleep quality/quantity...
September 25, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#13
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#14
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28915175/when-the-letter-f-meets-the-letter-d-beneficial-impact-of-open-visiting-and-family-presence-on-incidence-of-delirium-among-icu-patients
#15
Alberto Giannini
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28911284/effect-of-nicotine-replacement-therapy-on-mortality-delirium-and-duration-of-therapy-in-critically-ill-smokers-a-systematic-review-and-meta-analysis
#16
K T Ng, M Gillies, D M Griffith
Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28910303/the-influence-of-analgesic-based-sedation-protocols-on-delirium-and-outcomes-in-critically-ill-patients-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Dan Liu, Jie Lyu, Huiying Zhao, Youzhong An
OBJECTIVE: To investigate the influence of analgesic-based midazolam sedation on delirium and outcomes in critically ill patients and to analyze the risk factors of delirium. DESIGN: Single center, prospective randomized controlled trial. SETTING: A surgical intensive care unit (ICU) in a tertiary care hospital in China. PATIENTS: Mechanically ventilated patients requiring sedation. MEASUREMENTS AND MAIN RESULTS: Patients admitted to the surgical intensive care unit who required sedation and were undergoing mechanical ventilation for longer than 24 hours were randomly divided into three groups: 1) the remifentanil group received remifentanil and midazolam, 2) the fentanyl group received fentanyl and midazolam, and 3) the control group received only midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#18
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28903083/delirium-characteristics-and-outcomes-in-medical-and-surgical-lnpatients-a-subgroup-analysis
#19
Sungmin Kim, Jae-Jin Kim, Jooyoung Oh, Jaesub Park, Jin Young Park
PURPOSE: Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. MATERIALS AND METHODS: Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28887627/-sepsis-masquerading-as-delirium
#20
REVIEW
A Seifert, C S Hartog, J Zweigner, W Schummer, K Reinhart
A previously healthy 60-year-old patient presented to the emergency department with severe headache, altered personality and fever. He was treated for bacterial meningitis with delirium of unknown cause but presumed to be due to alcohol withdrawal. Despite receiving the antibiotic therapy regimen recommended for bacterial meningitis the patient's condition rapidly deteriorated with profound delirium and tachypnea. The intensivist who was consulted immediately suspected sepsis-associated organ failure and admitted the patient to the intensive care unit (ICU)...
September 8, 2017: Der Anaesthesist
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