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Delirium critical care

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https://www.readbyqxmd.com/read/28523698/survey-among-critical-care-nurses-and-physicians-about-delirium-management
#1
Peter Nydahl, Michael Dewes, Rolf Dubb, Carsten Hermes, Arnold Kaltwasser, Susanne Krotsetis, Rebecca von Haken
BACKGROUND: Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. AIM: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. DESIGN: The study used an open online survey with multiple-choice responses...
May 18, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28508438/the-effect-of-chronotherapy-on-delirium-in-critical-care%C3%A2-%C3%A2-a-systematic-review
#2
Roseanne Luther, Anne McLeod
BACKGROUND: Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. AIM: This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? DESIGN: This study is a systematic review of quantitative studies...
May 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#3
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28495595/low-plasma-leptin-level-at-admission-predicts-delirium-in-critically-ill-patients-a-prospective-cohort-study
#4
Guicheng Li, Xiaobao Lei, Chenmu Ai, Tao Li, Zhongqing Chen
The pathophysiology of delirium remains poorly understood. Low leptin level has been associated with features leading to delirium such as dysregulated immune functions and loss of neuroprotective effects. The purpose of the present study was to investigate the relationship between plasma leptin level at intensive care unit (ICU) entry and subsequent occurrence of delirium in critically ill patients. This single-center prospective cohort study in China allocated 336 critically ill patients admitted to ICU between 05/2015 and 05/2016 into a delirium group (n=102) and non-delirium group (n=234) based on whether delirium occurred during their stay at the ICU...
May 8, 2017: Peptides
https://www.readbyqxmd.com/read/28487184/symptom-assessment-in-non-vocal-or-cognitively-impaired-icu-patients-implications-for-practice-and-future-research
#5
REVIEW
JiYeon Choi, Margaret L Campbell, Céline Gélinas, Mary Beth Happ, Judith Tate, Linda Chlan
BACKGROUND: Symptom assessment in critically ill patients is challenging because many cannot provide a self-report. OBJECTIVES: To describe the state of the science on symptom communication and the assessment of selected physical symptoms in non-vocal ICU patients. METHODS: This paper summarizes a 2014 American Thoracic Society Annual International Conference symposium presenting current evidence on symptom communication, delirium, and the assessment of common physical symptoms (i...
May 6, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28461551/organizational-domains-and-variation-in-attitudes-of-intensive-care-providers-toward-the-abcde-bundle
#6
Leanne M Boehm, Eduard E Vasilevskis, Mary S Dietrich, Nancy Wells, E Wesley Ely, Pratik Pandharipande, Lorraine C Mion
BACKGROUND: The ABCDE interprofessional bundle (Awakening and Breathing Coordination, Delirium monitoring and management, and Early mobility) reduces delirium and weakness in critically ill patients. OBJECTIVE: To understand the relationship between organizational domains and provider attitudes. METHODS: A 1-time electronic survey of 315 care providers in 10 intensive care units across the country to examine associations between organizational domains (policy/protocol factors, unit milieu, tasks, labor quality, labor quantity, and physical environment) and provider attitudes about perceived ease of completion, perceived safety, confidence, and perceived strength of evidence regarding the ABCDE bundle...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28459497/assessment-of-delirium-in-intensive-care-unit-patients-educational-strategies
#7
Judith M Smith, M Nancy Van Aman, Mary Elizabeth Schneiderhahn, Robin Edelman, Patrick M Ercole
BACKGROUND: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently. METHOD: A pretest-posttest design was used to evaluate the success of a multimodal educational strategy (i...
May 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#8
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
May 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#9
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#10
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28410038/critical-care-nurses-knowledge-and-practice-of-delirium-assessment
#11
Gabby Rowley-Conwy
AIMS: The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice. BACKGROUND: Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#12
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28401613/implementing-augmentative-and-alternative-communication-in-critical-care-settings-perspectives-of-healthcare-professionals
#13
Charlotte Handberg, Anna Katarina Voss
AIM: The aim of the current study was to describe the perspectives of healthcare professionals caring for intubated patients on implementing Augmentative and Alternative Communication (AAC) in critical care settings. BACKGROUND: Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalization and rehabilitation...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28388984/case-control-study-on-risk-factors-of-unplanned-extubation-based-on%C3%A2-patient-safety-model-in-critically-ill-patients-with-mechanical-ventilation
#14
EunOk Kwon, KyungSook Choi
PURPOSE: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. METHODS: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay...
March 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28375992/pain-agitation-and-delirium-guidelines-interprofessional-perspectives-to-translate-the-evidence
#15
Juliane Jablonski, Jaime Gray, Todd Miano, Gretchen Redline, Heather Teufel, Tara Collins, Jose Pascual-Lopez, Martha Sylvia, Niels D Martin
BACKGROUND: Societal guidelines exist for the management of pain, agitation, and delirium (PAD) in critically ill patients. This contemporary practice aims for a more awake and interactive patient. Institutions are challenged to translate the interrelated multivariable concepts of PAD into daily clinical practice and to demonstrate improvement in quality outcomes. An interdisciplinary goal-directed approach shows outcomes in high-acuity surgical critical care during the early stages of implementation...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#16
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28363933/feasibility-of-melatonin-for-prevention-of-delirium-in-critically-ill-patients-a-protocol-for-a-multicentre-randomised-placebo-controlled-study
#17
Lisa Burry, Damon Scales, David Williamson, Jennifer Foster, Sangeeta Mehta, Melanie Guenette, Eddy Fan, Michael Detsky, Azar Azad, Francis Bernard, Louise Rose
INTRODUCTION: Delirium is highly prevalent in the intensive care unit (ICU) and is associated with adverse clinical outcomes. At this time, there is no drug that effectively prevents delirium in critically ill patients. Alterations in melatonin secretion and metabolism may contribute to the development of delirium. Administration of exogenous melatonin has been shown to prevent delirium in non-critically ill surgical and medical patients. This trial will demonstrate the feasibility of a planned multicentre, randomised controlled trial to test the hypothesis that melatonin can prevent delirium in critically ill patients compared with placebo...
March 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28358177/survey-on-monitoring-analgesia-and-sedation-in-the-italian-pediatric-intensive-care-units
#18
Benedicta Tabacco, Claudio Tacconi, Angela Amigoni
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study is to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing co- ordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28351551/effect-of-nocturnal-sound-reduction-on-the-incidence-of-delirium-in-intensive-care-unit-patients-an-interrupted-time-series-analysis
#19
Ineke van de Pol, Mat van Iterson, Jolanda Maaskant
INTRODUCTION: Delirium in critically-ill patients is a common multifactorial disorder that is associated with various negative outcomes. It is assumed that sleep disturbances can result in an increased risk of delirium. This study hypothesized that implementing a protocol that reduces overall nocturnal sound levels improves quality of sleep and reduces the incidence of delirium in Intensive Care Unit (ICU) patients. METHODS: This interrupted time series study was performed in an adult mixed medical and surgical 24-bed ICU...
March 25, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28335673/modifiable-risk-factors-for-delirium-in-critically-ill-trauma-patients
#20
Marc-Alexandre Duceppe, David R Williamson, Audrée Elliott, Mélissa Para, Marie-Christine Poirier, Marie-Soleil Delisle, Dan Deckelbaum, Tarek Razek, Monique Desjardins, Jean-Claude Bertrand, Francis Bernard, Philippe Rico, Lisa Burry, Anne Julie Frenette, Marc Perreault
OBJECTIVE: Intensive care unit (ICU)-acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU. DESIGN: Prospective observational study. SETTING: Two level 1 trauma ICU centers...
January 1, 2017: Journal of Intensive Care Medicine
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