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Delirium managment

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https://www.readbyqxmd.com/read/28933208/non-st-elevation-acute-coronary-syndromes-timing-and-selection-of-early-invasive-management-ecg-monitoring-need-dapt-duration-pathogenesis-of-recurrence-and-beware-of-delirium-in-the-intensive-acute-cardiac-care-unit
#1
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
#2
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/28904515/psychogenic-polydipsia-management-challenges
#3
M S Bhatia, Aparna Goyal, Rashmita Saha, Nimisha Doval
Compulsive water drinking or psychogenic polydipsia is now increasingly seen in psychiatric populations. Effects of increased water intake can lead to hyponatremia causing symptoms of nausea, vomiting, seizures, delirium and can even be life threatening if not recognized and managed early. Here we present a 35-year old adult who was diagnosed with psychogenic polydipsia and was successfully managed with a combination of pharmacotherapy, fluid restriction and psychosocial management.
June 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28894686/risk-factors-for-delirium-after-spine-surgery-in-extremely-elderly-patients-aged-80-years-or-older-and-review-of-the-literature-japan-association-of-spine-surgeons-with-ambition-multicenter-study
#4
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Kei Yamada, Michio Hongo, Yuji Matsuoka, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28887931/extracorporeal-membrane-oxygenation-management-techniques-to-liberate-from-extracorporeal-membrane-oxygenation-and-manage-post-intensive-care-unit-issues
#5
REVIEW
Joseph B Zwischenberger, Harrison T Pitcher
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique when patients require pulmonary and/or cardiac support for days to weeks for recovery, bridge to decision, or transplantation. Due to complications associated with ECMO, it is best to stay on ECMO as little time as necessary. Foremost is weaning from ECMO, but the post-ECMO period recapitulates the entire field of critical care. Identified issues include (1) potential for systemic inflammatory response syndrome post-decannulation; (2) post-ECMO complications, such as deep vein thrombosis, wounds, renal failure, and stroke; (3) delirium; (4) posttraumatic stress disorder; (5) rehabilitation; and (6) end of life...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#6
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28873217/geriatrics-literature-2016-year-in-review
#7
Kaitlin Willham, Kenneth Covinsky, Eric Widera
We present 10 of the most effective articles from 2016 in geriatric medicine. They address wide-ranging topics including the use of antipsychotics for delirium in palliative care, fall prevention and mobility interventions, efficacy and potential risks of testosterone, cranberry capsules and their effect on bacteriuria and pyuria, beta-blockers after acute myocardial infarction in a nursing home population, the effect of a healthy lifestyle on disability, a goals-of-care intervention in individuals with advanced dementia, the benefits of regional anesthesia in hip repair, and mindfulness in chronic pain management...
September 5, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28870776/consensus-report-by-palisi-and-pbmtc-joint-working-committees-supportive-care-guidelines-for-management-of-vod-in-children-and-adolescents-part-3-focus-on-cardio-respiratory-dysfunction-infections-liver-dysfunction-and-delirium
#8
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multi-organ dysfunction (MOD) and multiple teams are involved in their daily care in the pediatric intensive care units (PICU). Cardio-respiratory dysfunction is critical in these patients as it needs immediate action. Whether to use non-invasive or invasive ventilation strategy may be a difficult decision in the setting of mucositis or other comorbidities in patients with VOD. Similarly monitoring of their organ functions could be very challenging; they may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28869145/the-early-diagnosis-and-management-of-mixed-delirium-in-a-patient-placed-on-ecmo-and-with-difficult-sedation-a-case-report
#9
María Acevedo-Nuevo, Maria Teresa González-Gil, Miguel Ángel Romera-Ortega, Ignacio Latorre-Marco, Maria Dolores Rodríguez-Huerta
Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula)...
August 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28868035/a-novel-stress-diathesis-model-to-predict-risk-of-post-operative-delirium-implications-for-intra-operative-management
#10
Renée El-Gabalawy, Ronak Patel, Kayla Kilborn, Caitlin Blaney, Christopher Hoban, Lawrence Ryner, Duane Funk, Regina Legaspi, Joseph A Fisher, James Duffin, David J Mikulis, W Alan C Mutch
Introduction: Risk assessment for post-operative delirium (POD) is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) carbon dioxide (CO2) stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28866898/olanzapine-induced-delirium-a-probable-adverse-drug-reaction
#11
David MacKintosh
Olanzapine is an atypical antipsychotic indicated for the treatment of schizophrenia and known to be effective in the management of delirium. In addition to its use for these indications olanzapine has also been used in the management of chemotherapy induced nausea and vomiting and otherwise difficult to control nausea and vomiting in palliative care settings. Although considered to be well tolerated with a lower incidence of extrapyramidal effects than first generation antipsychotics there are a small number of reports of olanzapine inducing delirium...
June 19, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#12
Shirley Harvey Bush, Sallyanne Tierney, Peter Gerard Lawlor
Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and is prevalent in up to 42% of patients admitted to palliative care inpatient units. The symptoms of delirium and its associated communicative impediment invariably generate high levels of patient and family distress. Furthermore, delirium is associated with significant patient morbidity and increased mortality in many patient populations, especially palliative care where refractory delirium is common in the dying phase. As the clinical diagnosis of delirium is frequently missed by the healthcare team, the case for regular screening is arguably very compelling...
September 1, 2017: Drugs
https://www.readbyqxmd.com/read/28858917/why-do-we-fail-to-deliver-evidence-based-practice-in-critical-care-medicine
#13
Curtis H Weiss
PURPOSE OF REVIEW: The use of evidence-based practices in clinical practice is frequently inadequate. Recent research has uncovered many barriers to the implementation of evidence-based practices in critical care medicine. Using a comprehensive conceptual framework, this review identifies and classifies the barriers to implementation of several major critical care evidence-based practices. RECENT FINDINGS: The many barriers that have been recently identified can be classified into domains of the consolidated framework for implementation research (CFIR)...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28857831/managing-delirium-behaviors-with-one-to-one-sitters
#14
Joan Colella, Dianne Aroh, Claudia Douglas, Nancy VanBuitenen, Jodi Galesi, Angelica Castro, Lisa Tank, Manisha Parulekar, Morey Menacker
No abstract text is available yet for this article.
September 2017: Nursing Management
https://www.readbyqxmd.com/read/28856665/discharge-plans-for-geriatric-inpatients-with-delirium-a-plan-to-stop-antipsychotics
#15
Kim G Johnson, Adedayo Fashoyin, Ramiro Madden-Fuentes, Andrew J Muzyk, Jane P Gagliardi, Mamata Yanamadala
BACKGROUND: Studies show inpatient geriatric patients with reversible conditions like delirium may continue on antipsychotic medications without clear indications after hospital discharge. We conducted this study to determine how often geriatric patients were discharged on a newly started antipsychotic during admission with a plan for discontinuation of the antipsychotic documented in the discharge summary. DESIGN: We conducted retrospective chart review identifying geriatric inpatients in our health system started on a new antipsychotic during admission...
August 30, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28851588/do-sedation-and-analgesia-contribute-to-long-term-cognitive-dysfunction-in-critical-care-survivors
#16
S Fernandez-Gonzalo, M Turon, C De Haro, J López-Aguilar, M Jodar, L Blanch
Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation. Over the last decade a vast body of literature has been generated regarding different sedation strategies, with the aim of reducing the levels of sedation in critically ill patients. There has also been a growing interest in acute brain dysfunction, or delirium, in the ICU. However, the effect of sedation during ICU stay upon long-term cognitive deficits in ICU survivors remains unclear...
August 26, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28843537/sophia-observation-withdrawal-symptoms-paediatric-delirium-scale-a-tool-for-early-screening-of-delirium-in-the-picu
#17
Erwin Ista, Harma Te Beest, Joost van Rosmalen, Matthijs de Hoog, Dick Tibboel, Babette van Beusekom, Monique van Dijk
BACKGROUND: Delirium in critically ill children is a severe neuropsychiatric disorder which has gained increased attention from clinicians. Early identification of delirium is essential for successful management. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale was developed to detect Paediatric Delirium (PD) at an early stage. OBJECTIVE: The aim of this study was to determine the measurement properties of the PD component of the SOS-PD scale in critically ill children...
August 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28841632/delirium-and-catatonia-in-critically-ill-patients-the-delirium-and-catatonia-prospective-cohort-investigation
#18
Jo E Wilson, Richard Carlson, Maria C Duggan, Pratik Pandharipande, Timothy D Girard, Li Wang, Jennifer L Thompson, Rameela Chandrasekhar, Andrew Francis, Stephen E Nicolson, Robert S Dittus, Stephan Heckers, E Wesley Ely
OBJECTIVES: Catatonia, a condition characterized by motor, behavioral, and emotional changes, can occur during critical illness and appear as clinically similar to delirium, yet its management differs from delirium. Traditional criteria for medical catatonia preclude its diagnosis in delirium. Our objective in this investigation was to understand the overlap and relationship between delirium and catatonia in ICU patients and determine diagnostic thresholds for catatonia. DESIGN: Convenience cohort, nested within two ongoing randomized trials...
August 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28836711/delirium-tremens-and-alcohol-withdrawal-nationally-in-the-veterans-health-administration
#19
David Thomas Moore, Brian Scott Fuehrlein, Robert Alan Rosenheck
BACKGROUND AND OBJECTIVES: Alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. METHODS: National Veterans Health Administration data from fiscal year 2012 were examined to identify veterans diagnosed with DT; with withdrawal but not DT (WNDT); and with Alcohol Use Disorder (AUD) but neither DT nor WNDT...
August 24, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28835871/multimodal-pain-management-in-older-elective-arthroplasty-patients
#20
Elaine Brooks, Susan H Freter, Susan K Bowles, David Amirault
BACKGROUND: Pain management after elective arthroplasty in older adults is complicated due to the risk of undertreatment of postoperative pain and potential adverse effects from analgesics, notably opioids. Using combinations of analgesics has been proposed as potentially beneficial to achieve pain control with lower opioid doses. OBJECTIVE: We compared a multimodal pain protocol with a traditional one, in older elective arthroplasty patients, measuring self-rated pain, incidence of postoperative delirium, quantity and cost of opioid analgesics consumed...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
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