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delirium management

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https://www.readbyqxmd.com/read/29474380/predisposing-and-precipitating-factors-for-delirium-in-community-dwelling-older-adults-admitted-to-hospital-with-this-condition-a-prospective-case-series
#1
Emmanuelle Magny, Hélène Le Petitcorps, Maria Pociumban, Zineb Bouksani-Kacher, Éric Pautas, Joël Belmin, Sylvie Bastuji-Garin, Carmelo Lafuente-Lafuente
BACKGROUND: Factors associated with delirium among community-dwelling older adults have been poorly studied. Our aim was to describe the prevalence of predisposing and precipitating factors for delirium among patients admitted for delirium and to assess whether these factors were appropriately recognized at the first patient assessment at hospital. METHODS: Consecutive community-dwelling individuals admitted to three geriatric acute care units with a confirmed initial diagnosis of delirium were prospectively included...
2018: PloS One
https://www.readbyqxmd.com/read/29464690/bis-monitoring-versus-clinical-assessment-for-sedation-in-mechanically-ventilated-adults-in-the-intensive-care-unit-and-its-impact-on-clinical-outcomes-and-resource-utilization
#2
REVIEW
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29457487/dementia-management-strategies-associated-with-neuropsychiatric-symptoms-of-elderly-people-with-alzheimer-s-disease
#3
Lais Lopes Delfino, Ricardo Shoiti Komatsu, Caroline Komatsu, Anita Liberalesso Neri, Meire Cachioni
This study aims to investigate the association between management and communication strategies and the presence of neuropsychiatric symptoms presented by elderly people with Alzheimer's disease. One hundred and thirty-four family caregivers answered a questionnaire with socio-demographic data and questions regarding the care context, the Small Communication Strategies Scale, the Dementia Management Strategy Scale, and the Neuropsychiatric Inventory. Caregivers used the criticism management strategy more when the elderly presented hallucination, agitation, depression, anxiety, irritability, nighttime behavior, and appetite abnormalities...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29441518/haloperidol-for-delirium-in-critically-ill-patients-protocol-for-a-systematic-review
#4
M Barbateskovic, S R Kraus, M O Collet, O Mathiesen, J C Jakobsen, A Perner, J Wetterslev
BACKGROUND: In the intensive care unit, the prevalence of delirium is high. Delirium has been associated with morbidity and mortality including more ventilator days, longer intensive care unit stay, increased long-term mortality, and cognitive impairment. Thus, the burden of delirium for patients, relatives, and societies is considerable. The objective of this systematic review was to critically access the evidence of randomised clinical trials on the effects of haloperidol vs. placebo or any other agents for delirium in critically ill patients...
February 14, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#5
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29432391/management-of-delirium-across-an-integrated-health-system
#6
Cynthia L Holle, James L Rudolph
No abstract text is available yet for this article.
February 9, 2018: Nursing Management
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/29426675/the-use-of-cerebral-imaging-for-investigating-delirium-aetiology
#8
Zina Hijazi, Peter Lange, Rosie Watson, Andrea B Maier
BACKGROUND: This study aims to investigate the frequency and patterns of use of cerebral imaging in delirium and to describe pathological changes associated with delirium using computed tomography (CT) and magnetic resonance imaging (MRI). METHODS: This retrospective observational study included patients with delirium admitted to a tertiary hospital (The Royal Melbourne Hospital, Australia) between January 2015 and August 2016. Data on cerebral imaging was collected and positive imaging findings were defined as: Acute or subacute infarct, haemorrhage, abscess, neoplasm, vasculitis, posterior reversible encephalopathy syndrome, encephalitis, acute demyelination, or fat embolism...
February 6, 2018: European Journal of Internal Medicine
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/29412842/palliative-care-for-dementia
#10
REVIEW
Jonathan T Stewart, Susan K Schultz
With the growing care needs for the older population at the end of their lives, there has been a substantial increase in attention to the management of the patient with dementia in hospice and palliative care services. This article reviews issues in access to care and the optimal management of the patient with dementia, particularly in the context of neuropsychiatric complexities. Special issues such as delirium, cachexia, behavioral symptoms, and pain management are addressed. Future challenges in research such as the development of better prognostic models are noted as well as the importance of attention to access to care...
March 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29411662/empowerment-environment-and-person-centred-care-a-qualitative-study-exploring-the-hospital-experience-for-adults-with-cognitive-impairment
#11
Laura Prato, Lyndsay Lindley, Miriam Boyles, Louise Robinson, Clare Abley
It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29409468/delirium-in-older-hospitalized-patients-signs-and-actions-a-retrospective-patient-record-review
#12
Yvonne A Johansson, Ingrid Bergh, Iréne Ericsson, Elisabeth Kenne Sarenmalm
BACKGROUND: Delirium is common in older hospitalized patients, and is associated with negative consequences for the patients, next of kin, healthcare professionals and healthcare costs. It is important to understand its clinical features, as almost 40% of all cases in hospitals may be preventable. Yet, delirium in hospitalized patients is often unrecognized and untreated. Few studies describe thoroughly how delirium manifests itself in older hospitalized patients and what actions healthcare professionals take in relation to these signs...
February 6, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29404834/managing-the-mental-distress-of-the-hematopoietic-stem-cell-transplant-hsct-patient-a-focus-on-delirium
#13
REVIEW
Joseph Bubalo
PURPOSE OF REVIEW: To highlight the breadth and types of mental distress experienced by hematopoietic stem cell transplant (HSCT) patients and highlight the need for better prevention and management of delirium. RECENT FINDINGS: Recent publications highlight additional risks factors which predict for mental distress during the HSCT process. Despite new medications and additional psychological reports, there is little progress in non-pharmacologic or medication therapy in the prevention and treatment of delirium...
February 5, 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#14
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29397135/perioperative-outcomes-in-the-context-of-mode-of-anaesthesia-for-patients-undergoing-hip-fracture-surgery-systematic-review-and-meta-analysis
#15
REVIEW
C M O'Donnell, L McLoughlin, C C Patterson, M Clarke, K C McCourt, M E McBrien, D F McAuley, M O Shields
BACKGROUND: Previous meta-analyses on the anaesthetic management of patients undergoing surgery for hip fracture have focused on randomized trials. Furthermore, heterogeneity in outcome reporting across the studies has made it difficult to inform best practice guidelines for patient care. METHODS: This systematic review examined how perioperative outcomes were reported and defined in the context of comparing modes of anaesthesia for hip fracture surgery. Outcomes were included from randomised and non-randomised studies published between January 2000 and July 2017...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29386096/cost-analysis-of-an-integrated-aged-care-program-for-residential-aged-care-facilities
#16
Rod Ling, Andrew Searles, Jacqueline Hewitt, Robyn Considine, Catherine Turner, Susan Thomas, Kelly Thomas, Keith Drinkwater, Isabel Higgins, Karen Best, Jane Conway, Carolyn Hullick
Objective To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents.Methods This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District...
February 1, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29378075/evidence-based-practice-guideline-delirium
#17
Patricia Finch Guthrie, Shelley Rayborn, Howard K Butcher
Delirium is a common cause of morbidity and mortality in hospitalized older adults often superimposed on dementia. Older patients with delirium are more likely than other populations to develop hospital-acquired infections, pressure ulcers, and immobility and nutritional issues, as well as to have increased health care costs, longer hospital stays, and long-term care following discharge. Interventions that prevent or mitigate the effects of delirium while promoting recovery are essential for caring for hospitalized older patients...
February 1, 2018: Journal of Gerontological Nursing
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
#18
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/29368313/the-use-of-point-of-care-ultrasound-to-diagnose-patent-foramen-ovale-in-elective-hip-and-knee-arthroplasty-patients-and-its-association-with-postoperative-delirium
#19
Nan Gai, Ronit Lavi, Philip M Jones, Hwa Lee, Douglas Naudie, Daniel Bainbridge
PURPOSE: Hip and knee arthroplasty surgeries are associated with embolism of materials such as air, cement, and fat. Patent foramen ovale (PFO) is a common congenital cardiac condition that has been reported to lead to paradoxical embolism. This observational study aimed to investigate if the presence of a PFO was associated with an increased risk of postoperative delirium in patients undergoing primary elective hip or knee arthroplasties. METHOD: This was a prospective cohort study at a tertiary teaching hospital...
January 24, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29362259/prognostic-factors-of-inhospital-death-in-elderly-patients-a-time-to-event-analysis-of-a-cohort-study-in-martinique-french-west-indies
#20
Lidvine Godaert, Seendy Bartholet, Fréderique Dorléans, Fatiha Najioullah, Sebastien Colas, Jean-Luc Fanon, André Cabié, Raymond Césaire, Moustapha Dramé
OBJECTIVE: The primary objective was to identify predictive factors of inhospital death in a population of patients aged 65 years or older hospitalised with Chikungunya virus (CHIKV) infection. The secondary aim was to develop and validate a predictive score for inhospital death based on the predictors identified. DESIGN: Longitudinal retrospective study from January to December 2014. SETTING: University Hospital of Martinique. PARTICIPANTS: Patients aged ≥65 years, admitted to any clinical ward and who underwent reverse transcription PCR testing for CHIKV infection...
January 23, 2018: BMJ Open
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