Tag: delirium
The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation
The focus on long-term consequences of critical illness has intensified with increasing ICU utilization and survivorship. Post Intensive Care Syndrome (PICS) is increasingly recognized and has profound and long-lasting negative... read more
Leading EHR System Adopts Bundle to Prevent ICU Delirium
Seminal studies at Vanderbilt University Medical Center over the past two decades by pulmonary and critical care specialist Wes Ely, M.D. and colleagues have spurred ICU delirium research, and the resulting body of evidence... read more
Impact of Natural Light Exposure on Delirium Burden in Adult Patients Receiving Invasive Mechanical Ventilation in the ICU
Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was... read more
Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients
The majority of patients in our study demonstrated signs that may be indicative of dexmedetomidine withdrawal. Peak and cumulative daily dexmedetomidine dose, rather than duration of therapy, may be associated with a higher... read more
Delirium is Prevalent in Older Hospital Inpatients and Associated with Adverse Outcomes
Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The... read more
Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium
In the primary analysis, limiting the level of sedation provided no significant benefit in reducing incident delirium. However, in a pre-specified subgroup analysis, lighter sedation levels benefitted reducing postoperative... read more
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
Effect of Flexible Family Visitation on Delirium Among Patients in the ICU
In this cluster-crossover randomized clinical trial that involved 1,685 patients in the intensive care unit (ICU), the incidence of delirium was 18.9% in the flexible family visitation group compared with 20.1% in the standard... read more
How To Prevent Brain-Sapping Delirium In The ICU
After an overwhelming infection sent O'Burke into five-organ failure, he also developed ICU delirium, perhaps related to heavy sedation. An ICU protocol developed at Vanderbilt University Medical Center found that getting... read more
Long-term Cognitive Impairment and Delirium in ICU
ICU delirium was positively associated with impaired information processing speed and executive functioning at six-months post-discharge for this cohort. Testing for cognitive impairment with RBANS and TMT should be considered... read more
Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?
Generally, the bundle was deemed acceptable and deliverable. However, like any complex intervention, component adaptations will be required depending on resources available to the ICU; in particular, involvement of pharmacists... read more
Effect of Organisational Factors on the Variation in Incidence of Delirium in ICU Patients
The mean incidence of delirium in the ICU was 29%. The organisational factors found including methods of delirium assessment, screening frequency, and hospital type were not related to the reported ICU delirium incidence. A... read more
Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children
The results highlight the heterogeneity in sedation practices among intensivists who care for critically ill children as well as a paucity of sleep promotion and delirium screening in PICUs worldwide. The survey was completed... read more
Antipsychotic Drugs are Not Useful to Reduce Symptoms of Delirium
In patients receiving palliative care, individualized management of delirium precipitants and supportive strategies result in lower scores and shorter duration of target distressing delirium symptoms than when risperidone... read more
Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients
Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status. 72 patients were included in the initial group and 72... read more
Cognitive Outcomes After Critical Illness
Persistent cognitive impairment is a major complication of critical illness. Our knowledge of this problem remains incomplete. Collaborative research is indispensable to improve our understanding of this disabling sequel... read more
Intra-Operative Events During Cardiac Surgery are Risk Factors for the Development of Delirium in the ICU
Risk factors for delirium following cardiac surgery are incompletely understood. The aim of this study was to investigate whether intra-operative pathophysiological alterations and therapeutic interventions influence... read more
Ramelteon for Prevention of Postoperative Delirium
Ramelteon 8 mg did not prevent postoperative delirium in patients admitted for elective cardiac surgery. Incident delirium was measured twice daily using the Confusion Assessment Method-ICU. The safety outcome was... read more
Antipsychotics Not Helpful for Delirium in ICU
Delirium is a confused mental state that includes changes in awareness, thinking, judgment, sleeping patterns, and behavior. It can affect patients of any age but is more common among older adults who experience major illness... read more
Physical Rehabilitation in the ICU
Survivors of critical illness frequently experience poor physical outcomes, including persistent impairments in muscle strength, exercise capacity and physical function. In this article, we review these impairments and... read more
Obstructive Sleep Apnea, Positive Airway Pressure Treatment and Postoperative Delirium
Obstructive sleep apnea (OSA) is common among older surgical patients, and delirium is a frequent and serious postoperative complication. Emerging evidence suggests that OSA increases the risk for postoperative delirium.... read more
