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Your search returned 27 results
from the time period: last 90 days.
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A validated, guideline-recommended, bedside delirium monitoring instrument-the Confusion Assessment Method for the ICU (CAM-ICU)-was used to assess for the presence or absence of delirium ... 28-day mortality, and patient disposition; time to first CAM-ICU becoming negative (delirium free) for a continuous 48-hour duration was also assessed ...
Cardiovascular Diseases (1)
Delirium (19), Hypertension (1), Sepsis (1), more mentions
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
Because of the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments because of critical illness, known as post-intensive care syndrome (PICS). This article focuses on PICS-related cognitive, psychological, and physical impairments and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS and what roles geriatric psychiatrists could play in the future of this rapidly growing population.
Delirium (1), more mentions
Journal of clinical nursing
AbstractText: To explore the incidence of delirium in cerebrovascular patients admitted in our Neurosurgery Intensive Care Unit (NICU) and analyze the risk factors leading to delirium AbstractText: Delirium is one of the most common mental disorders in general ... term clinical outcomes daily AbstractText: On the basis of CAM-ICU evaluation, patients were divided into a delirium group and a non-delirium group ...
Delirium (13), Sleep Deprivation (2), Mental Disorders (1), more mentions
Critical care medicine
Predefined secondary outcomes included duration of delirium/coma; any ICU-acquired infection; ICU-acquired bloodstream infection, pneumonia, and urinary tract infection; all-cause ... between the two study groups AbstractText: In this medical-surgical ICU, an extended visitation model was associated with reduced occurrence of delirium and shorter length of delirium/coma and ICU stay ...
Urology (1)
Delirium (8), Coma (3), Infections (3), more mentions
British journal of anaesthesia
Background: Delirium is common after surgery, although the aetiology is poorly defined. Brain-derived neurotrophic factor (BDNF) is a neurotrophin important in neurotransmission and neuroplasticity. Decreased levels of BDNF have been associated with poor cognitive outcomes, but few studies have characterized the role of BDNF perioperatively. We hypothesized that intraoperative decreases in BDNF levels are associated with postoperative delirium. Methods: Patients undergoing spine surgery were enrolled in a prospective cohort study. Plasma BDNF was collected at baseline and at least hourly intraoperatively. Delirium was assessed using rigorous methods, including the Confusion Assessment Method (CAM) and CAM for the intensive care unit. Associations of changes in BDNF and delirium were examined using regression models. Results: Postoperative delirium developed in 32 of 77 (42%) patients. The median baseline BDNF level was 7.6 ng ml -1 [interquartile range (IQR) 3.0-11.2] and generally declined intraoperatively [median decline 61% (IQR 31-80)]. There was no difference in baseline BDNF levels by delirium status. However, the percent decline in BDNF was greater in patients who developed delirium [median 74% (IQR 51-82)] vs in those who did not develop delirium [median 50% (IQR 14-79); P =0.03]. Each 1% decline in BDNF was associated with increased odds of delirium in unadjusted {odds ratio [OR] 1.02 [95% confidence interval (CI) 1.00-1.04]; P =0.01}, multivariable-adjusted [OR 1.02 (95% CI 1.00-1.03); P =0.03], and propensity score-adjusted models [OR 1.02 (95% CI 1.00-1.04); P =0.03]. Conclusions: We observed an association between intraoperative decline in plasma BDNF and delirium. These preliminary results need to be confirmed but suggest that plasma BDNF levels may be a biomarker for postoperative delirium.
Delirium (13), more mentions
Critical care medicine
... Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines AbstractText: Worldwide online survey AbstractText: Intensive care AbstractText: A cross-sectional online survey using the Delphi method was ... reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.
Delirium (6), more mentions
... 30 (4.4%), followed by a length of stay in the ICU < 24 hours 18 (2.6%) and delirium before ICU admission 13 (1.9 ... We developed the model using 11 related factors to predict delirium in critically ill patients and further determined that prophylaxis with Dexmedetomidine Hydrochloride in delirious ICU patients was beneficial ...
Neuroscience (1), Cardiovascular Diseases (1)
Delirium (10), Nervous System Diseases (4), Coma (2), more mentions
Critical care medicine
... this investigation was to understand the overlap and relationship between delirium and catatonia in ICU patients and determine diagnostic thresholds for catatonia AbstractText: Convenience cohort ... two usual care sedation regimens AbstractText: Patients were assessed for delirium and catatonia by independent and masked personnel using Confusion Assessment Method for the ICU and the Bush Francis Catatonia Rating Scale mapped to Diagnostic ...
Catatonia (15), Delirium (12), more mentions
Critical care (London, England)
Four studies used the Intensive Care Delirium Screening Checklist (ICDSC) and two used the Confusion Assessment Method ... The use of antipsychotics in SSD patients to prevent delirium was evaluated in two studies but it did not modify ICU LOS (6.5 (4-8) vs 7 (4-9) days, p ... clear conclusion about the association between SSD and progression to delirium or worse ICU clinical outcomes Keyword: Critically ill.
Neuroscience (1)
Delirium (8), more mentions
BMJ open
AbstractText: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population ... Furthermore, in the general ICU population, it has been shown that the duration of delirium is associated with worse long-term cognitive function ... of dexmedetomidine to propofol for treatment of hyperactive and mixed delirium in the ICU.
Delirium (17), more mentions
Provision of adequate sedation is a fundamental part of caring for critically ill patients. Propofol, dexmedetomidine, and benzodiazepines are the most commonly administered sedative medications for adult patients in the intensive care unit (ICU). These agents are limited by adverse effects, need for a monitored environment for safe administration, and lack of universal effectiveness. Recently, there has been increased interest in repurposing older pharmacologic agents for patient comfort in the intensive care unit. Valproate, enteral clonidine, and phenobarbital are three agents with increasing evidence supporting their use. Potential benefits associated with their utilization are cost minimization and safe administration after transition out of the ICU. The purpose of this literature review is to describe the historical context, pharmacologic characteristics, supportive data, and practical considerations associated with the administration of these agents for comfort in critically ill adult patients. This article is protected by copyright. All rights reserved.
Delirium (1), more mentions
BMJ open
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities. This protocol describes an observational study with the aim of determining if delirium in the first hour following tracheal tube removal is a predictor of delirium in the 5 subsequent postoperative days. Improved understanding regarding the development of postoperative delirium would improve patient care and allow more effective implementation of delirium prevention measures. METHODS AND ANALYSIS: Patients enrolled to the Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) randomised controlled trial will be eligible for this substudy. A validated delirium assessment method, the 3-min Diagnostic Confusion Assessment Method and the Richmond Agitation and Sedation Scale will be used to assess 100 patients for delirium at 30 min and 60 min following tracheal tube removal. Patients will also be assessed for delirium over postoperative days 1-5 using three validated methods, the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit and structured chart review. Logistic regression analysis will then be performed to test whether immediately postoperative delirium independently predicts subsequent postoperative delirium. ETHICS AND DISSEMINATION: This observational substudy of ENGAGES has been approved by the ethics board of Washington University School of Medicine. Enrolment began in June 2016 and will continue until June 2017. Dissemination plans include presentations at scientific conferences and scientific publications. TRIAL REGISTRATION NUMBER: NCT02241655.
Delirium (16), Altered Level of Consciousness (1), more mentions
Journal of critical care 
Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4) AbstractText: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days. Delirious patients received more low-potency anticholinergic (P <0.0001), antipsychotic (P <0.0001), benzodiazepine (P <0.0001 ...
Delirium (9), more mentions
The Lancet. Respiratory medicine
... placebo daily for up to a maximum of 28 days, irrespective of coma or delirium status. We assessed delirium using the Confusion Assessment Method for the ICU (CAM-ICU. The primary outcome was number of days alive and was assessed as delirium-free and coma-free in the first 14 days after being randomly allocated to receive treatment or placebo.
Delirium (10), Coma (5), more mentions
The oncologist
AbstractText: To improve the management of advanced cancer patients with delirium in an emergency department (ED) setting, we compared outcomes between patients with delirium positively diagnosed by both the Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS), or group A (n = 22); by the MDAS only, or group ...
Oncology (10), Men's Health (8)
Delirium (15), Neoplasms (10), more mentions
PloS one
... critically ill patients and to analyze the risk factors of delirium.Single center, prospective randomized controlled trial.A surgical intensive care unit (ICU) in a tertiary care hospital in China.Mechanically ventilated patients ... compare the effect of different therapies on the occurrence of delirium, days of mechanical ventilation, length of the ICU stay, and 28-day mortality were measured along with the risk factors for delirium ...
Delirium (11), more mentions
PloS one
Secondary outcome measures included ICU discharge after-hours, incidence of delirium, survival to hospital discharge, discharge destination, the incidence of ICU acquired infections, revocation of ICU discharge decision, unplanned readmissions to ICU within 72 hours, review of patients admitting team after ICU discharge decision AbstractText: A total of 955 out ...
Delirium (1), Infections (1), more mentions
Journal of critical care 
... investigated the impact of delirium on illness severity, psychological state, and memory in acute respiratory distress syndrome patients with very long ICU stay AbstractText: Prospective cohort study in the medical-surgical ICUs of 2 teaching hospitals. Very long ICU stay (>75days) and prolonged delirium (≥40days) thresholds were determined by ROC analysis. Subjects were ≥18years, full-code, and provided informed consent.
Delirium (7), Adult Respiratory Distress Syndrome (2), Post-Traumatic Stress Disorders (2), more mentions
The Journal of clinical psychiatry
We examined whether suvorexant, a potent and selective orexin receptor antagonist, is effective for the prevention of delirium AbstractText: We conducted a multicenter, rater-blinded, randomized, placebo-controlled clinical trial in intensive care units and regular acute wards between April 2015 and March 2016. Eligible patients were 65 to 89 years old, newly admitted due to emergency, and able to ...
Delirium (10), more mentions
Journal of the American Geriatrics Society
... interventional processes AbstractText: Two tertiary referral hospitals in Australia AbstractText: Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905) AbstractText: Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention ...
Men's Health (3)
Delirium (11), Aspiration Pneumonia (1), more mentions
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