Tag: delirium

Prediction of ICU Delirium

The predictive models evaluated in this study demonstrated moderate to good discriminative ability to predict ICU patients' risk of developing delirium. Models calculated at 24-hours post-ICU admission appear to be more accurate... read more

Sedation in ICU patients – Need for Standardized Protocols

A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes.... read more

Safety of Patient Mobilization and Rehabilitation in the ICU

Patient mobilization and physical rehabilitation in the ICU appears safe, with a low incidence of potential safety events, and only rare events having any consequences for patient management. Heterogeneity in the definition... read more

Use of the Confusion Assessment Method in Multi-center Delirium Trials

Delirium occurs commonly in older adults and is associated with adverse outcomes. Multi-center clinical trials evaluating interventions to prevent delirium are needed. The Confusion Assessment Method (CAM) is a validated... read more

Occupational Therapy for Delirium Management in Elderly Patients without Mechanical Ventilation in an ICU

Delirium has negative consequences such as increased mortality, hospital expenses and decreased cognitive and functional status. This research aims to determine the impact of occupational therapy intervention in duration,... read more

Low-dose Nocturnal Dexmedetomidine Prevents ICU Delirium

Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring... read more

A Protocol of No Sedation for Critically Ill Patients Receiving Mechanical Ventilation

Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. Daily interruption of sedation has a beneficial effect, and in the general ICU of Odense University Hospital, Denmark,... read more

Association of ICU Delirium with Sleep Disturbance and Functional Disability After Critical Illness

After adjusting for important covariates, total days of MICU delirium were significantly associated with increased post-discharge sleep disturbance. Delirium incidence showed a trend toward association with increased functional... read more

Age- and Gender-related Peculiarities of Patients with Delirium in the Cardiac ICU

Our investigation presented a number of associated peculiarities related to gender and age. It was shown that delirium is a severe complication that more often affects men amongst patients < 65 years old and more frequently... read more

The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU

The CAM-ICU-7 delirium severity scale is a valid, reliable, and practical delirium severity measure among ICU patients that can be easily calculated and is associated with meaningful clinical outcomes. This practical tool... read more

Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery

Among older patients undergoing cardiac surgery, postoperative scheduled IV acetaminophen, combined with IV propofol or dexmedetomidine, reduced in-hospital delirium vs placebo. Additional research, including comparison of... read more

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more

Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness

The Hospital Elder Life Program is effective in reducing incidence of delirium and rate of falls, with a trend toward decreasing length of stay and preventing institutionalization. With ongoing efforts in continuous program... read more

Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU

The majority of included studies indicated that benzodiazepine use in the ICU is associated with delirium, symptoms of posttraumatic stress disorder, anxiety, depression, and cognitive dysfunction. Future well-designed studies... read more

Haloperidol for the Management of Delirium in Adult ICU Patients

Among critically ill patients, haloperidol administration compared with placebo does not significantly affect short-term mortality, incidence of delirium, ICU length of stay, or delirium or coma-free days. Additionally, there... read more

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