Tag: delirium
Taming the Ketamine Tiger
THOSE who anesthetize patients with ketamine (originally given the clinical investigation number CI-581) realize it is a unique pharmacological agent. Ever since its introduction into human clinical anesthesia, ketamine has... read more
A Familiar Story: Delirium in the Acute Care Setting
A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate,... read more
Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients
First-, second-, and third-generation cephalosporins doubled the odds of delirium after baseline co-morbidities, ICU type, the course of critical care, and other competing antimicrobial and psychotropic medication risks were... read more
Caring for Critically Ill Patients with the ABCDEF Bundle
ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge... read more
Remodeling ICU Care
A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both... read more
The Effectiveness of Non-Pharmacological Interventions in Reducing the Incidence and Duration of Delirium in Critically Ill Patients
Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent... read more
Delirium in Critical Illness: Haloperidol vs Ziprasidone?
Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients. This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality,... read more
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals
The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more
No more antipsychotics for delirium? Not so fast!
Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more
Early Mobilization in the PICU
Mobilization of critically ill children, many with central lines, endotracheal tubes, and other life-saving devices, is associated with potential risks and complications. Hence, concerns about safety often guide staff perceptions... read more
Prevalence for Delirium in Stroke Patients
These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies... read more
Dopamine Antagonists in ICU Delirium
Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia
Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more
