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Delirium critical care

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
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
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
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
Sean van Diepen, Wendy I Sligl, Jeffrey B Washam, Ian C Gilchrist, Rakesh C Arora, Jason N Katz
Over the past half century, coronary care units have expanded from specialized ischemia arrhythmia monitoring units into intensive care units (ICUs) for acutely ill and medically complex patients with a primary cardiac diagnosis. Patients admitted to contemporary coronary intensive care units (CICUs) are at risk for common and preventable critical care complications, yet many CICUs have not adopted standard-of-care prevention protocols and practices from general ICUs. In this article, we (1) review evidence-based interventions and care bundles that reduce the incidence of ventilator-associated pneumonia, excess sedation during mechanical ventilation, central line infections, stress ulcers, malnutrition, delirium, and medication errors and (2) recommend pragmatic adaptations for common conditions in critically ill patients with cardiac disease, and (3) provide example order sets and practical CICU protocol implementation strategies...
July 1, 2016: Canadian Journal of Cardiology
S Sivakumar, F S Taccone, K A Desai, C Lazaridis, M Skarzynski, M Sekhon, W Henderson, D Griesdale, L Chapple, A Deane, L Williams, R Strickland, K Lange, D Heyland, M Chapman, M J Rowland, P Garry, J Westbrook, R Corkill, C A Antoniades, K T Pattinson, G Fatania, A J Strong, R B Myers, C Lazaridis, C M Jermaine, C S Robertson, C G Rusin, J Hofmeijer, L Sondag, M C Tjepkema-Cloostermans, A Beishuizen, F H Bosch, M J A M van Putten, L Carteron, C Patet, D Solari, M Oddo, M A Ali, C Dias, R Almeida, A Vaz-Ferreira, J Silva, E Monteiro, A Cerejo, A P Rocha, A A Elsayed, A M Abougabal, B N Beshey, K M Alzahaby, S Pozzebon, A Blandino Ortiz, S Cristallini, O Lheureux, A Brasseur, J L Vincent, J Creteur, F S Taccone, M Hravnak, K Yousef, Y Chang, E Crago, R M Friedlander, S A Abdelmonem, S A Tahon, T A Helmy, H S Meligy, F Puig, I Dunn-Siegrist, J Pugin, S Gupta, D Govil, S Srinivasan, S J Patel, J K N, A Gupta, D S Tomar, M Shafi, R Harne, D P Arora, N Talwar, S Mazumdar, E E Papakrivou, D 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 Santibañez, M Le Guen, J Moore, N Mason, M Windpassinger, O Plattner, E Mascha, D I Sessler, Outcomes Research, U Melia, J Fontanet, J P van den Berg, M M R F Struys, H E M Vereecke, E W Jensen, P J T Rood, F van de Schoor, K van Tertholen, P Pickkers, M van den Boogaard, Z J Beardow, H Redhead, K Paramasivam, T Numan, M van den Boogaard, A M Kamper, P Rood, L M Peelen, P M Zeman, A J Slooter, C E van Ewijk, G E Jacobs, A R J Girbes, S N Myatra, M M Harish, N R Prabu, S Siddiqui, A P Kulkarni, J V Divatia, L D Murbach, M A Leite, E F Osaku, C R L M Costa, M Pelenz, N M Neitzke, M M Moraes, J L Jaskowiak, M M M Silva, R S Zaponi, L R L Abentroth, S M Ogasawara, A C Jorge, P A D Duarte, N Hernández-Sánchez, L A Sánchez-Hurtado, F J García-Guillen, S A Ñamendys-Silva, B Maghsoudi, M Emami, M B Khosravi, F Zand, H R Tabatabaie, M Masjedi, G Sabetiyan, A Mokri, J Troubleyn, M Diltoer, R Jacobs, D N Nguyen, E De Waele, J De Regt, P M Honoré, V Van Gorp, H D Spapen, R S Contreras, N D 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Liu, F Shen, J L Teboul, N Anguel, A Beurton, N Bezaz, C Richard, X Monnet, T Fossali, R Colombo, D Ottolina, M Rossetti, C Mazzucco, A Marchi, A Porta, E Catena, K H Tollisen, G Ø Andersen, F Heyerdahl, D Jacobsen, M C de Waard, A R J Girbes, M C O van IJzendoorn, H Buter, W P Kingma, G J Navis, E C Boerma, J Rulisek, M Balik, S Zacharov, H S Kim, S J Jeon, H Namgung, E Lee, E Lee, Y J Cho, Y J Lee, A Huang, L Cioccari, N Luethi, J Mårtensson, R Bellomo, M Forsberg, G Edman, J Höjer, S Forsberg, M T Chiquito Freile, F N Hidalgo, J A Martinez Molina, R Lecumberri, A Figuerola Rosselló, P Medrano Travieso, G Tuero Leon, J Gonzalez Sanchez, L Sahuquillo Frias, D Balsells Rosello, J A Garcia Verdejo, J A Noria Serrano, D Winterwerp, T van Galen, A Vazin, I Karimzade, A Zand, E Ozen, S Ekemen, A Akcan, E Sen, B Buyukkidan Yelken, N Kureshi, L Fenerty, G Thibault-Halman, M Erdogan, S Walling, R S Green, D B Clarke, P Briassoulis, K Kalimeris, A Ntzouvani, T Nomikos, K Papaparaskeva, E Politi, G Kostopanagiotou, K Crewdson, M Rehn, A Weaver, K Brohi, D Lockey, S Wright, K Thomas, C Baker, L Mansfield, V Stafford, C Wade, G Watson, A Bryant, T Chadwick, J Shen, J Wilkinson, J Furneval, A Henderson, K Hugill, P Howard, A Roy, S Bonner, S Baudouin, C Sánchez Ramírez, S Hípola Escalada, M A Hernández Viera, M Cabrera Santana, L Caipe Balcázar, N Sangil Monroy, F Artiles Campelo, C F Lübbe Vázquez, P Saavedra Santana, S Ruiz Santana, L Carteron, C Patet, H Quintard, D Solari, P Bouzat, M Oddo, T Wollersheim, J Malleike, K Haas, N Carbon, J Schneider, C Birchmeier, J Fielitz, S Spuler, S Weber-Carstens, L Enseñat, A Pérez-Madrigal, P Saludes, L Proença, G Gruartmoner, C Espinal, J Mesquida, W Huber, M Eckmann, F Elkmann, A Gruber, T Lahmer, U Mayr, A Herner, R Schellnegger, J Schneider, R M Schmid, W Ayoub, W Samy, A Esmat, A Battah, S Mukhtar, W Mongkolpun, D Orbegozo Cortés, C P R Cordeiro, J L Vincent, J Creteur, S Funcke, H Groesdonk, B Saugel, G Wagenpfeil, S Wagenpfeil, D A Reuter, M M Fernandez, R Fernandez, M Magret, A González-Castro, M T Bouza, M Ibañez, C García, B Balerdi, A Mas, V Arauzo, J M Añón, F Ruiz, J Ferreres, R Tomás, M Alabert, A I Tizón, S Altaba, N Llamas, E C Goligher, E Fan, M Herridge, S Vorona, M Sklar, M Dres, N Rittayamai, A Lanys, C Urrea, G Tomlinson, W D Reid, G D Rubenfeld, B P Kavanagh, L J Brochard, N D Ferguson, A Serpa Neto, M Gama de Abreu, P Pelosi, M J Schultz, C Guérin, L Papazian, J Reignier, L Ayzac, A Loundou, J M Forel, C Rolland-Debord, C Bureau, T Poitou, M Clavel, S Perbet, N Terzi, A Kouatchet, T Similowski, A Demoule, N Hunfeld, Z Trogrlic, S Ladage, R J Osse, B Koch, W Rietdijk, J Devlin, M van der Jagt, E Picetti, P Ceccarelli, F Mensi, L Malchiodi, S Risolo, I Rossi, M V Antonini, F Servadei, M L Caspani, A Roquilly, S Lasocki, P Seguin, T Geeraerts, P F Perrigault, C Dahyot-Fizelier, C Paugam-Burtz, F Cook, R Cinotti, D Demeure Dit Latte, P J Mahe, C Fortuit, F Feuillet, K Asehnoune, C Marzorati, S Spina, V Scaravilli, A Vargiolu, M Riva, C Giussani, E Sganzerla, G Citerio, S Barbadillo, F J González de Molina, F Álvarez-Lerma, A Rodríguez, T Zakharkina, I Martin-Loeches, S Matamoros, P Povoa, A Torres, J Kastelijn, J J Hofstra, M de Jong, M Schultz, P Sterk, A Artigas, L J Bos, A S Moreau, I Martin-Loeches, P Povoa, J Salluh, A Rodriguez, S Nseir, E de Jong, J A van Oers, A Beishuizen, A R J Girbes, M W N Nijsten, D W de Lange, D Bonvicini, D Labate, L Benacchio, A Olivieri, E Pizzirani, J C Lopez-Delgado, M Gonzalez-Romero, V Fuentes-Mila, D Berbel-Franco, I Romera-Peregrina, A Martinez-Pascual, J Perez-Sanchez, R Abellan-Lencina, R E Ávila-Espinoza, G Moreno-Gonzalez, F Sbraga, S Griffiths, M P W Grocott, B Creagh-Brown, J Doyle, P Wilkerson, Y Soon, S Huddart, M Dickinson, A Riga, A Zuleika, K Miyamoto, Y Kawazoe, T Morimoto, T Yamamoto, A Fuke, A Hashimoto, H Koami, S Beppu, Y Katayama, M Ito, Y Ohta, H Yamamura, S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner, I W Soliman, D W de Lange, D van Dijk, J J M van Delden, O L Cremer, A J C Slooter, L M Peelen, D McWilliams, C Snelson, A Das Neves, C I Loudet, M Busico, D Vazquez, D Villalba, M Veronesi, A Lischinsky, F J L López, L Benito Mori, G Plotnikow, A Díaz, S Giannasi, R Hernandez, L Krzisnik, C Cecotti, L Viola, R Lopez, J P Sottile, G Benavent, E Estenssoro, C M Chen, C C Lai, K C Cheng, W Chou, K S Chan, L E Roeker, C M Horkan, F K Gibbons, K B Christopher, P J M Weijs, K M Mogensen, J D Rawn, M K Robinson, K B Christopher, Z Tang, C Qiu, B Ouyang, C Cai, X Guan, T Regueira, L Cea, S Juan Carlos, B Elisa, C Puebla, A Vargas, M K Poulsen, L P Thomsen, S Kjærgaard, S E Rees, D S Karbing, T Wollersheim, S Frank, M C Müller, N M Carbon, V Skrypnikov, P A Pickerodt, R Falk, A Mahlau, S Weber-Carstens, A Lee, R Inglis, R Morgan, G Barker, K Kamata, T Abe, D Saitoh, Y Tokuda, R S Green, M B Butler, M Erdogan, H Tae Hwa, L Jae Gil, R Hernández Vaquero, E Rodriguez-Ruiz, A Lopez Lago, J L Garcia Allut, A Estany Gestal, M A Garcia Gonzalez, D O Thomas-Rüddel, D Schwarzkopf, C Fleischmann, K Reinhart, S Suwanpasu, Y Sattayasomboon, N M Filgueiras Filho, J C A Oliveira, C S Ballalai, C V De Lucia, G P Araponga, L N Veiga, C S Silva, M E Garrido, B B Ramos, E F Ricaldi, S S Gomes, L Gemmell, A MacKay, C Wright, R I Docking, P Doherty, E Black, P Stenhouse, M P Plummer, M E Finnis, L K Phillips, P Kar, S Bihari, V Biradar, S Moodie, M Horowitz, J E Shaw, A M Deane, T Yatabe, S Inoue, M Sakaguchi, M Egi, Y Ali Abdelhamid, M P Plummer, M E Finnis, L K Phillips, P Kar, S Bihari, V Biradar, S Moodie, M Horowitz, J E Shaw, A M Deane, M Hokka, M Egi, S Mizobuchi, P Kar, M Plummer, Y Ali Abdelhamid, E Giersch, M Summers, S Hatzinikolas, S Heller, M Chapman, K Jones, M Horowitz, A Deane, R Schweizer, M Jacquet-Lagreze, P Portran, S Junot, B Allaouchiche, J L Fellahi, P Guerci, B Ergin, A Kapucu, C Ince, L Cioccari, N Luethi, M Crisman, R Bellomo, J Mårtensson, C Righy Shinotsuka, D Fagnoul, A Brasseur, D Orbegozo, J L Vincent, J C Preiser, J C Preiser, O Lheureux, A Thooft, S Brimioulle, J L Vincent, H Iwasaka, S Tahara, M Nagamine, A Ichigatani, A Rugerio Cabrera, E Monares Zepeda, J Franco Granillo, J S Aguirre Sánchez, A A Tanaka Montoya, A Pedraza Montenegro, G A Gálvez Blanco, C M Coronado Robles, A Drolz, T Horvatits, K Roedl, K Rutter, S Kluge, G C Funk, B Schneeweiss, V Fuhrmann, G Sabetian, F Pooresmaeel, F Zand, S Ghaffaripour, A Farbod, H Tabei, L Taheri, R Anandanadesan, V Metaxa, C Teixeira, S M Pereira, P Hernández-Marrero, A S Carvalho, M Beckmann, C S Hartog, D Schwarzkopf, A Raadts, A Robertsen, R Førde, N O Skaga, E Helseth, S Honeybul, K Ho, P Martinez Lopez, M Nieto Gonzalez, P Nuevo Ortega, E Camara Sola, T Spasova, M V de la Torre-Prados, O Kopecky, K Rusinova, P Waldauf, Z Cepeplikova, M Balik, J Palamidessi Domínguez, P Matia Almudevar, S Alcántara Carmona, J J Rubio Muñoz, D Palacios Castañeda, A Naharro Abellán, P Rodríguez Villamizar, J Veganzones Ramos, L Pérez Pérez, A Pérez Lucendo, M Camós Ejarque, A Estella, V Lopez Camps, M C Martín, N Masnou, S Barbosa, A Varela, I Palma, L Cristina, E Nunes, I Pereira, G Campello, C Granja, R Pande, M Pandey, S Varghese, M Chanu, M J Van Dam, E W M T Ter Braak, A Estella, M Gracia, R Viciana, M Recuerda, L Perez Fontaiña, B Tharmalingam, F Kovari, L Rose, M Mcginlay, R Amin, K Burns, B Connolly, N Hart, P Jouvet, S Katz, D Leasa, C Mawdsley, D Mcauley, M Schultz, B Blackwood, S Denham, R Worrall, M Arshad, P Isherwood, A Khadjibaev, D Sabirov, A Rosstalnaya, F Parpibaev, V Sharipova, G A Galvez Blanco, C I Olvera Guzman, J S Aguirre Sánchez, J Franco Granillo, S Gupta, D Govil, S Srinivasan, S J Patel, J K N, A Gupta, M Shafi, D S Tomar, R Harne, D P Arora, N Talwar, S Mazumdar, Y S Cha, S J Lee, N Tyagi, R K Rajput, S Taneja, V K Singh, S C Sharma, S Mittal, B K Rao, J Ayachi, N Fraj, S Romdhani, A Khedher, K Meddeb, N Sma, A Azouzi, R Bouneb, I Chouchene, M El Ghardallou, M Boussarsar, R Jennings, E Walter, J M Ribeiro, I Moniz, R Marçal, A C Santos, C Candeias, Z Costa E Silva, S E Zamora Gomez, O R Perez Nieto, J A Castanon Gonzalez, A I Vasquez Cuellar, H Mildh, V Pettilä, A M Korhonen, S Karlsson, T Ala-Kokko, M Reinikainen, S T Vaara, M Zaleska-Kociecka, M Grabowski, M Dąbrowski, S Wozniak, K Piotrowska, M Banaszewski, J Imiela, J Stepinska, 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, J Koeze, F Keus, W Dieperink, I C C van der Horst, M van Meurs, J G Zijlstra, S Roberts, C Hernandez Caballero, G Isgro, D Hall, S Beitland, A-M S Trøseid, B S Brusletto, B E Waldum-Grevbo, J P Berg, K Sunde, D García Huertas, F Manzano, M M Jiménez- Quintana, A Osuna, F Santiago-Ruiz, C Rodríguez-Mejías, R Wangensteen, H R Jamaati, M Masjedi, F Zand, S M R Hashemian, G Sabetian, G Abbasi, V Khaloo, S H A Tabei, A Kafilzadeh, H Haddad Bakhodaei, J A Diaz, R Silva, D J Garcia, E Luis, M N Gomez, R Soriano, P L Gonzalez, I A Ibrahim, M M Rafik, A M Al-Ansary, M A Algendi, A A Ali, V Fuhrmann, K Roedl, T Horvatits, A Drolz, K Rutter, D Benten, J Kluwe, S Siedler, S Kluge, I Adedugbe, G T Bird, R M Kennedy, S Sharma, M B Butler, G Yugi, B A Haroon, T Witter, W Khaliq, M Singer, A A Havaldar, B Krishna, S Sriram, E D Valenzuela Espinoza, M O Pozo, V S Kanoore Edul, M Furche, M F Motta, A Risso Vazquez, P N Rubatto Birri, C Ince, A Dubin, A Dogliotti, A Ramos, C Lovesio, E Delile, R Nevière, P-A Thiébaut, J Maupoint, P Mulder, D Coquerel, S Renet, J C do Rego, J Rieusset, V Richard, F Tamion, W Khaliq, D T Andreis, M Singer, B Smit, Y M Smulders, M C de Waard, H M Oudemans van Straaten, A R J Girbes, E C Eringa, A M E Spoelstra-de Man, L Alegría, D Soto, C Luengo, J Gomez, N Jarufe, A Bruhn, R Castro, E Kattan, P Tapia, R Rebolledo, P Achurra, G Ospina-Tascón, J Bakker, G Hernández, P Bertini, F Guarracino, R Baldassarri, M R Pinsky, L Alegría, M Vera, J Dreyse, D Carpio, C Henriquez, D Gajardo, S Bravo, R Castro, G Ospina-Tascón, J Bakker, G Hernández, S Kim, M Lee, S Y Park, S So, H Lee, M B Kačar, S M Kačar, I Uddin, A M Belhaj, M A Aydın, D Avsec, A Kapuağası, Ç Kaymak, L Kovach, I Şencan, B Meço, M Özçelik, N Ünal, C Lazaridis, B Jenni-Moser, M-M Jeitziner, M S Galassi, F L Sales, K C L de Moraes, C L Batista, J A de Souza Júnior, T B Marcari, R Lobato, C S A A Castro, L M de Souza, F F P Rodrigues, N G Correa, A M Pelegrini, R A C Eid, K T Timenetsky, D Cazati, M Lobato, P S Diniz, L L Rocha, A M Cavalheiro, N M Lucinio, E R Santos, M Norrenberg, A Gleize, J C Preiser, I Fernández Simón, S Alcántara Carmona, I Lipperheide Valhonrat, J Palamidessi Domínguez, A Naharro Abellán, P Matía Almudévar, F Dávila, J J Rubio, A J Ramos, Á J Roldán Reina, N Palomo López, M Adriaensens Pérez, D X Cuenca Apolo, L Martín Villén, F M Porras López, I Palacios García, J R Naranjo 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No abstract text is available yet for this article.
September 2016: Intensive Care Medicine Experimental
Wayne Varndell, Margaret Fry, Doug Elliott
AIM: This systematic review examined the psychometric properties and suitability of the available observational pain instruments for potential use with nonverbal critically ill adult patients in the emergency department. BACKGROUND: In the emergency department assessing pain in critically ill patients is challenging, especially those unable to communicate the presence of pain. Critically ill patients are commonly unable to verbally communicate pain due to altered oral communication (e...
September 29, 2016: Journal of Clinical Nursing
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
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
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
Dewi Stalpers, Dimitri van der Linden, Marian J Kaljouw, Marieke J Schuurmans
BACKGROUND: Deliberate screening allows detection of health risks that are otherwise not noticeable and allows expedient intervention to minimize complications and optimize outcomes, especially during critical events like hospitalization. Little research has evaluated the usefulness of screening performance and outcome indicators as measures to differentiate nursing quality, although policymakers are using them to benchmark hospitals. OBJECTIVES: The aims of this study were to examine hospital performance based on nursing-sensitive screening indicators and to assess associations with hospital characteristics and nursing-sensitive outcomes for patients...
September 2016: Nursing Research
Tracy A Smith, Meera Agar, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
OBJECTIVE: Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure. DESIGN: Qualitative face-to-face interviews analysed using thematic analysis. SETTING: Australian tertiary teaching hospital...
August 26, 2016: BMJ Supportive & Palliative Care
Brian J Anderson, John P Reilly, Michael G S Shashaty, Jessica A Palakshappa, Alex Wysoczanski, Thomas G Dunn, Altaf Kazi, Anna Tommasini, Mark E Mikkelsen, William D Schweickert, Dennis L Kolson, Jason D Christie, Nuala J Meyer
PURPOSE: Neuron-specific enolase (NSE) concentrations are prognostic following traumatic and anoxic brain injury and may provide a method to quantify neuronal injury in other populations. We determined the association of admission plasma NSE concentrations with mortality and delirium in critically ill septic patients. METHODS: We performed a retrospective analysis of 124 patients from a larger sepsis cohort. Plasma NSE was measured in the earliest blood draw at intensive care unit admission...
June 23, 2016: Journal of Critical Care
Deena Kelly Costa, Jennifer Dammeyer, Matthew White, Jose Galinato, Robert Hyzy, Milisa Manojlovich, Anne Sales
BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU...
2016: BMC Research Notes
Nicole Palazzolo, Bridgette Kram, Andrew J Muzyk
OBJECTIVE: To determine the extent of QTc prolongation following administration of an atypical antipsychotic in critically ill patients diagnosed with delirium and to conduct an assessment of risk factors to identify the presence of specific risk factors associated with QTc prolongation in this patient population. METHODS: Patients were included if they were at least 18 years of age, admitted to an Intensive Care Unit (ICU) at the study institution from July 1, 2013 through January 30, 2014, had a documented diagnosis of delirium within their electronic medical record, and received an atypical antipsychotic for delirium during their hospital admission...
August 15, 2016: Current Drug Safety
Chani Traube, Elizabeth A Mauer, Linda M Gerber, Savneet Kaur, Christine Joyce, Abigail Kerson, Charlene Carlo, Daniel Notterman, Stefan Worgall, Gabrielle Silver, Bruce M Greenwald
OBJECTIVE: To determine the costs associated with delirium in critically ill children. DESIGN: Prospective observational study. SETTING: An urban, academic, tertiary-care PICU in New York city. PATIENTS: Four-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All children were assessed for delirium daily throughout their PICU stay...
August 11, 2016: Critical Care Medicine
Satoshi Honda, Toshiyuki Nagai, Yasuo Sugano, Atsushi Okada, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Hisao Ogawa, Satoshi Yasuda, Toshihisa Anzai
BACKGROUND: Delirium is a serious syndrome in critically ill patients. However, the prognostic impact of delirium and its determinants in acute heart failure (AHF) patients have not been fully elucidated. METHODS: We examined 611 AHF patients who were admitted to our institution. Delirium was diagnosed based on the Intensive Care Delirium Screening Checklist (ICDSC). RESULTS: Delirium developed in 139 patients (23%) during hospitalization...
November 1, 2016: International Journal of Cardiology
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