16,380 results match your criteria Delirium


Assessment of analgesia, sedation, physical restraint and delirium in patients admitted to Spanish intensive care units. Proyecto ASCyD.

Enferm Intensiva 2019 Apr 16. Epub 2019 Apr 16.

Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España.

Aims: Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR.

Method: An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Read More

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http://dx.doi.org/10.1016/j.enfi.2018.11.002DOI Listing

Patient Satisfaction with Oral Versus Intravenous Sedation for Cataract Surgery : A Randomized Clinical Trial.

Ophthalmology 2019 Apr 16. Epub 2019 Apr 16.

Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA.

Purpose: To determine whether patient satisfaction with oral sedation is non-inferior to intravenous (IV) sedation for cataract surgery.

Design: A prospective, randomized, double-masked clinical trial.

Subjects: A volunteer sample of patients age 18 or older from diverse ethnic, racial, and socioeconomic backgrounds scheduled for cataract surgery. Read More

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http://dx.doi.org/10.1016/j.ophtha.2019.04.022DOI Listing

Early Mobilization Post-Hip Fracture Surgery.

Geriatr Orthop Surg Rehabil 2019 7;10:2151459319826431. Epub 2019 Apr 7.

Flinders University Faculty of Medicine, Nursing and Health Sciences, Adelaide, South Australia, Australia.

Introduction: Early mobilization after hip fracture surgery is a widely practiced component of postoperative care. However, there is little evidence to suggest that early mobilization post-hip fracture surgery is beneficial in reducing postoperative complications. This study aims to investigate the effect of early mobilization following hip fracture surgery on postoperative complications. Read More

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http://dx.doi.org/10.1177/2151459319826431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454638PMC
April 2019
1 Read

Pharmacological Prevention of Postoperative Delirium: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Evid Based Complement Alternat Med 2019 14;2019:9607129. Epub 2019 Mar 14.

Department of Intensive Care Unit, West China Hospital of Sichuan University, Chengdu, China.

Background: The high prevalence of delirium among postoperative patients has increased morbidity and mortality. The kind of drug that can effectively reduce the incidence of delirium has become the focus of discussion in recent years. However, a consensus in this respect has yet to be reached. Read More

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http://dx.doi.org/10.1155/2019/9607129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437723PMC

The neurological syndromes associated with glutamic acid decarboxylase antibodies.

J Autoimmun 2019 Apr 15. Epub 2019 Apr 15.

Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA; University of Guanajuato, Mexico. Electronic address:

A number of neurological syndromes have been described in patients with positive serum antibodies (Abs) against the enzyme glutamic acid decarboxylase (GAD), the rate limiting step in the synthesis of GABA (γ-aminobutyric acid). These disorders include: classical stiff-person syndrome and variants, cerebellar ataxia, limbic and extra-limbic encephalitis, nystagmus/oculomotor dysfunction, drug-resistant epilepsy, paraneoplastic stiff-person syndrome and progressive encephalopathy with rigidity and myoclonus (PERM), the latter two are mainly related to amphiphysin and the glycine receptor Abs respectively; but patients may also have positive GAD-Abs. Although observations are consistent with an autoimmune response in these patients and there is evidence of GABAergic dysfunction in some cases; the pathogenic role of GAD-Abs in the nervous system has not been clarified and it is a matter of debate. Read More

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http://dx.doi.org/10.1016/j.jaut.2019.04.007DOI Listing
April 2019
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Risk factors for postoperative delirium in patients undergoing microvascular decompression.

PLoS One 2019 18;14(4):e0215374. Epub 2019 Apr 18.

Department of Pain, Lanzhou University Second Hospital, Lanzhou, Gansu Province, People's Republic of China.

This study is to identify the risk factors for postoperative delirium (PODE) in patients undergoing microvascular decompression (MVD) for the treatment of primary cranial nerve disorders. We retrospectively reviewed the data of 912 patients (354 men, 558 women) with primary cranial nerve disorders (trigeminal neuralgia, 602 patients; hemifacial spasm, 296 patients; glossopharyngeal neuralgia, 14 patients) who underwent MVD in the Neurosurgery Department of Lanzhou University Second Hospital between July 2007 and June 2018. Potential risk factors for PODE were identified using univariate and multivariate stepwise logistic regression analysis. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215374PLOS
April 2019
2 Reads

Preoperative stratification for postoperative delirium: obstructive sleep apnea is a predictor, the STOP-BANG is not?

J Thorac Dis 2019 Mar;11(Suppl 3):S202-S206

Department of Anaesthesia and Critical Care Medicine, Policlinico Umberto 1 Hospital, Sapienza University of Rome, Rome, Italy.

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http://dx.doi.org/10.21037/jtd.2019.02.33DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424745PMC
March 2019
1 Read

Delirium after Cardiac Surgery and Cognitive Change: Reply.

Anesthesiology 2019 May;130(5):859

Johns Hopkins University School of Medicine, Baltimore, Maryland (C.H.B.).

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http://dx.doi.org/10.1097/ALN.0000000000002699DOI Listing
May 2019
1 Read

Delirium after Cardiac Surgery and Cognitive Change: Comment.

Anesthesiology 2019 05;130(5):857-859

Vanderbilt University Medical Center, Nashville, Tennessee (C.B.).

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http://dx.doi.org/10.1097/ALN.0000000000002698DOI Listing
May 2019
1 Read

The Cornell Assessment of Pediatric Delirium: Translation and inter-rater reliability in a Danish pediatric intensive care unit.

Acta Anaesthesiol Scand 2019 Apr 17. Epub 2019 Apr 17.

Department of Anesthesiology and Intensive Care, East Section, Aarhus University Hospital, Aarhus, Denmark.

Background: Delirium is a serious medical problem and recognized as a common syndrome in critically ill children. Without routine screening, delirium diagnosis is often missed by the medical providers. Internationally, there are tools to assess pediatric delirium (PD), but none currently available in Danish. Read More

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http://dx.doi.org/10.1111/aas.13369DOI Listing
April 2019
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Update in Neurocritical Care: a summary of the 2018 Paris international conference of the French Society of Intensive Care.

Ann Intensive Care 2019 Apr 16;9(1):47. Epub 2019 Apr 16.

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.

The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current standards for the clinical assessment of altered consciousness states (including coma and delirium) and peripheral nervous system in critically ill patients, monitoring of brain function (specifically, electro-encephalography) and best practices for sedation-analgesia-delirium management. An update on the treatment of specific severe brain pathologies-including ischaemic/haemorrhagic stroke, cerebral venous thrombosis, hypoxic-ischaemic brain injury, immune-mediated and infectious encephalitis and refractory status epilepticus-was also provided. Read More

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http://dx.doi.org/10.1186/s13613-019-0523-xDOI Listing
April 2019
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Use of the confusion assessment method in multicentre delirium trials: training and standardisation.

BMC Geriatr 2019 Apr 15;19(1):107. Epub 2019 Apr 15.

Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD96RJ, UK.

Background: Delirium occurs commonly in older adults and is associated with adverse outcomes. Multicentre clinical trials evaluating interventions to prevent delirium are needed. The Confusion Assessment Method (CAM) is a validated instrument for delirium detection. Read More

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http://dx.doi.org/10.1186/s12877-019-1129-8DOI Listing
April 2019
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Distinguishing characteristics of delirium in a skilled nursing facility in Spain: Influence of baseline cognitive status.

Int J Geriatr Psychiatry 2019 Apr 16. Epub 2019 Apr 16.

Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Psiquiatric Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain.

Objective: Mild cognitive impairment (MCI) and dementia (DEM) are prevalent in skilled nursing facilities (SNF), confounding delirium detection. We report characteristics of delirium in a SNF to ascertain distinguishing features for delirium diagnosis, despite challenges of comorbidity with MCI and DEM.

Methods: Cross-sectional study of 200 consecutive patients from a SNF in Catalunya, Spain; assessed within the first 24-48 admission hours by independent experts with: Spanish-Informant Questionnaire on Cognitive Decline in the Elderly (for MCI-DEM), DSM-5 delirium criteria, and Delirium Rating Scale Revised-98 (DRS-R98) for delirium phenomenology. Read More

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http://dx.doi.org/10.1002/gps.5120DOI Listing
April 2019
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Dissociation of identity following left parietal haematoma - a single case report.

Australas Psychiatry 2019 Apr 16:1039856219839480. Epub 2019 Apr 16.

Senior Clinical Lecturer, Department of Psychiatry, University of Sydney, Sydney, NSW, and; Senior Staff Specialist, Mood Disorders Unit, Cumberland Hospital, Westmead, NSW, and; Consultant Psychiatrist, St John of God Health, North Richmond, NSW, Australia.

Objectives: Dissociative identity disorder in relation to brain injury has only rarely been reported in literature. This case report, which illustrates a de novo onset of dissociative identity for the first time in an elderly man who had a left parietal haematoma, adds to this scant literature base and supports an integrative view of bridging the dichotomy between organic and functional to explain complex psychiatric phenomena.

Methods: It is a single case report collected through serial semi-structured interviews of the patient and his family over a 12-week period. Read More

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http://dx.doi.org/10.1177/1039856219839480DOI Listing
April 2019
2 Reads

Delirium after primary percutaneous coronary intervention in aged individuals with acute ST-segment elevation myocardial infarction: A retrospective study.

Exp Ther Med 2019 May 14;17(5):3807-3813. Epub 2019 Mar 14.

Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230061, P.R. China.

The present prospective study aimed to investigate the incidence and risk factors of delirium after primary percutaneous coronary intervention (PCI) in older adults with acute ST-segment elevation myocardial infarction (STEMI). A total of 111 patients (age, ≥65 years) with acute STEMI following primary PCI were included in the present study. Neurocognitive testing was performed using the Mini-mental State Examination on the first day of hospitalization. Read More

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http://dx.doi.org/10.3892/etm.2019.7398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447909PMC
May 2019
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Rethinking our approach to delirium: The potential of proactivity.

J Psychosom Res 2019 Apr 10. Epub 2019 Apr 10.

Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

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https://linkinghub.elsevier.com/retrieve/pii/S00223999193044
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http://dx.doi.org/10.1016/j.jpsychores.2019.04.006DOI Listing
April 2019
2 Reads

Entrustable Professional Activity 10: Recognizing the Acutely Ill Patient-A Delirium Simulated Case for Students in Emergency Medicine.

MedEdPORTAL 2016 Dec 2;12:10512. Epub 2016 Dec 2.

Associate Professor, Department of Emergency Medicine, Oregon Health & Science University School of Medicine.

Introduction: This simulation case was designed to evaluate the ability of third- and fourth-year emergency medicine clerkship students and acting interns to perform the tasks outlined in the Association of American Medical College's Core Entrustable Professional Activity 10, to "recognize a patient requiring urgent or emergent care and initiate evaluation and management." The overarching goal is to assess medical students' ability to recognize and take steps to stabilize a sick patient.

Methods: In this case, students encounter a physician, simulated with a high-fidelity manikin, who has suddenly become confused. Read More

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http://dx.doi.org/10.15766/mep_2374-8265.10512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440403PMC
December 2016
1 Read

Staged Implementation of Awakening and Breathing, Coordination, Delirium Monitoring and Management, and Early Mobilization Bundle Improves Patient Outcomes and Reduces Hospital Costs.

Crit Care Med 2019 Apr 10. Epub 2019 Apr 10.

Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Objectives: To measure the impact of staged implementation of full versus partial ABCDE bundle on mechanical ventilation duration, ICU and hospital lengths of stay, and cost.

Design: Prospective cohort study.

Setting: Two medical ICUs within Montefiore Healthcare Center (Bronx, NY). Read More

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http://dx.doi.org/10.1097/CCM.0000000000003765DOI Listing
April 2019
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In the ICU - delirium post cardiac arrest.

Curr Opin Crit Care 2019 Apr 9. Epub 2019 Apr 9.

Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: The present review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium.

Recent Findings: Patient factors leading to a cardiac arrest, initial resuscitation efforts, and postresuscitation management all influence the potential for recovery and the risk for development of delirium. Data suggest that delirium in cardiac arrest survivors is an independent risk factor for morbidity and mortality. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000615DOI Listing
April 2019
2 Reads

Noteworthy Literature Published in 2018 for Cardiothoracic Anesthesiologists.

Semin Cardiothorac Vasc Anesth 2019 Apr 15:1089253219842651. Epub 2019 Apr 15.

1 Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.

The year 2018 was marked by high-quality, impactful articles spanning the basic, translational, and clinical spectrum in the field of cardiothoracic anesthesia. In this article, we present several hand-picked articles from the past year that we feel were the most significant in shaping our specialty. Large multicenter, randomized controlled trials presenting clinical outcome data dominated the publishing arena: is a restrictive red blood cell transfusion strategy superior to a liberal red blood cell transfusion strategy during cardiopulmonary bypass? Does a low mean arterial blood pressure strategy during cardiopulmonary bypass increase stroke incidence? Does the obesity paradox apply to cardiac surgery? Advancing technology continues to revolutionize our field: can the MitraClip be used to effectively treat secondary mitral regurgitation? Can stem cells improve cardiac function in patients with left ventricular assist devices? These studies allow us to shape our practice in an evidence-based manner, so that we may evolve as a specialty and deliver the best care to our patients. Read More

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http://dx.doi.org/10.1177/1089253219842651DOI Listing
April 2019
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Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis.

Neuroimage Clin 2019 Apr 3;23:101809. Epub 2019 Apr 3.

Department of Intensive Care Medicine and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Delirium is an acute neuropsychiatric syndrome characterized by altered levels of attention and awareness with cognitive deficits. It is most prevalent in elderly hospitalized patients and related to poor outcomes. Predisposing risk factors, such as older age, determine the baseline vulnerability for delirium, while precipitating factors, such as use of sedatives, trigger the syndrome. Read More

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http://dx.doi.org/10.1016/j.nicl.2019.101809DOI Listing
April 2019
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Midazolam: Safety of use in palliative care: A systematic critical review.

Biomed Pharmacother 2019 Apr 10;114:108838. Epub 2019 Apr 10.

Department of Palliative Medicine, Poznan University of Medical Sciences, Poland.

Purpose: The undesired effects of midazolam can be life-threatening. This paper delineates the findings related to the pharmacokinetics, adverse effects and drug-drug interactions as well as associated therapeutic implications for safe midazolam use.

Methods: A systematic review of literature was conducted. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07533322193059
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http://dx.doi.org/10.1016/j.biopha.2019.108838DOI Listing
April 2019
4 Reads

Hyperammonemia after capecitabine associated with occult impairment of the urea cycle.

Cancer Med 2019 Apr 11. Epub 2019 Apr 11.

Department of Biochemistry, Stanford University, Stanford, California.

Background: Cancer patients receiving chemotherapy often complain of "chemobrain" or cognitive impairment, but mechanisms remain elusive.

Methods: A patient with gastric cancer developed delirium and hyperammonemia after chemotherapy with the 5-fluorouracil pro-drug capecitabine. Exome sequencing facilitated a search for mutations among 43 genes associated with hyperammonemia and affecting the urea cycle directly or indirectly. Read More

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http://dx.doi.org/10.1002/cam4.2036DOI Listing
April 2019
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Preliminary investigation of predictors of distress in informal caregivers of patients with delirium superimposed on dementia.

Aging Clin Exp Res 2019 Apr 11. Epub 2019 Apr 11.

Department of Rehabilitation, Fondazione Camplani Casa di Cura "Ancelle della Carità", Via Aselli 16, 26100, Cremona, Italy.

Objective: Delirium superimposed on dementia (DSD) is common and associated with adverse outcomes. Current evidence indicates that some patients with dementia may recall delirium with distress for them and their caregivers. The aim of this study is to identify predictors of distress in informal caregivers of older patient with DSD. Read More

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http://dx.doi.org/10.1007/s40520-019-01194-7DOI Listing
April 2019
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Delayed retroperitoneal hemorrhage during veno-venous extracorporeal membrane oxygenation: a case report.

Acute Med Surg 2019 Apr 10;6(2):180-184. Epub 2019 Jan 10.

Department of Emergency Medicine Sapporo Medical University Sapporo Hokkaido Japan.

Case: There are several reports of retroperitoneal hemorrhage induced by percutaneous femoral cannulation for extracorporeal membrane oxygenation (ECMO). However, there are no reports of delayed retroperitoneal hemorrhage, which develops a few days after ECMO initiation and is unrelated to the ECMO cannulation. Herein, we report a rare case of delayed retroperitoneal hemorrhage during veno-venous extracorporeal membrane oxygenation (VV-ECMO). Read More

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http://dx.doi.org/10.1002/ams2.385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442533PMC
April 2019
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Reducing Delirium and Improving Patient Satisfaction With a Perioperative Mindfulness Intervention: A Mixed-Methods Pilot Study.

Holist Nurs Pract 2019 May/Jun;33(3):163-176

Icahn School of Medicine at Mount Sinai, New York (Drs Lisann-Goldman and Deiner); Mount Sinai West/Mount Sinai St Luke's, New York (Dr Lisann-Goldman); Università Cattolica del Sacro Cuore, Milan, Italy (Dr Pagnini); and Harvard University, Boston, Massachusetts (Drs Pagnini and Langer).

Postoperative delirium (incidence estimated up to 82%) can be ameliorated with nonpharmacologic methods. Mindfulness has not yet been incorporated into these methods, although mindfulness has been demonstrated to help patients adapt to illness and hospitalization. To reduce postoperative delirium incidence and increase patient satisfaction, this study employs a program of thought exercises based on Langerian mindfulness. Read More

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http://dx.doi.org/10.1097/HNP.0000000000000321DOI Listing
April 2019
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The prevalence of frailty among acute stroke patients, and evaluation of method of assessment.

Clin Rehabil 2019 Apr 10:269215519841417. Epub 2019 Apr 10.

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Objective: We aimed to determine prevalence of pre-stroke frailty in acute stroke and describe validity of a Frailty Index-based assessment.

Design: Cross-sectional.

Setting: Single UK urban teaching hospital. Read More

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http://dx.doi.org/10.1177/0269215519841417DOI Listing
April 2019
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Postoperative cognitive decline: the nurse's role in identifying this underestimated and misinterpreted condition.

Authors:
Luca Di Santo

Br J Nurs 2019 Apr;28(7):414-420

Research Nurse, Academic Neuroscience Centre, King's College Hospital, London.

Background: postoperative cognitive changes can increase morbidity and mortality, demand for postoperative care and social and health costs, and can lead to dementia.

Aim: this article discusses perioperative variables that can be used to identify patients who are more vulnerable to experiencing cognitive decline after surgery. It also highlights some screening tools that could be useful for early detection and for planning nursing care. Read More

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http://dx.doi.org/10.12968/bjon.2019.28.7.414DOI Listing
April 2019
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Stimulant Therapy in Acute Traumatic Brain Injury: Prescribing Patterns and Adverse Event Rates at 2 Level 1 Trauma Centers.

J Intensive Care Med 2019 Apr 9:885066619841603. Epub 2019 Apr 9.

4 Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background/objective: Pharmacological stimulant therapies are routinely administered to promote recovery in patients with subacute and chronic disorders of consciousness (DoC). However, utilization rates and adverse drug event (ADE) rates of stimulant therapies in patients with acute DoC are unknown. We aimed to determine the frequency of stimulant use and associated ADEs in intensive care unit (ICU) patients with acute DoC caused by traumatic brain injury (TBI). Read More

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http://dx.doi.org/10.1177/0885066619841603DOI Listing
April 2019
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Knowledge, opinions and clinical practice regarding postoperative delirium in older patients: A survey of nurses and anaesthetists.

J Clin Anesth 2019 Apr 6;57:108-109. Epub 2019 Apr 6.

National Health Service (NHS), Edinburgh, City of Edinburgh, United Kingdom. Electronic address:

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http://dx.doi.org/10.1016/j.jclinane.2019.04.004DOI Listing
April 2019
4 Reads

Executive Summary: Post-Intensive Care Syndrome in the Neurocritical Intensive Care Unit.

J Neurosci Nurs 2019 Apr 5. Epub 2019 Apr 5.

Questions or comments about this article may be directed to Cynthia A. Bautista, PhD APRN FNCS, at She is an Associate Professor, Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT. Peter Nydahl, MScN RN, is Nurse Researcher, University Hospital of Schleswig-Holstein, Kiel, Germany. Mary Kay Bader, MSN RN CCNS FNCS FAHA, is Neuro/Critical Care Clinical Nurse Specialist, Mission Hospital, Mission Viejo, CA. Sarah Livesay, DNP RN FNCS, is Associate Professor, Rush University College of Nursing, Chicago, IL. Anne-Kathrin Cassier-Woidasky, PhD RN, is Professor, Nursing Sciences, Baden-Wuerttemberg, Cooperative State University, Stuttgart, Germany. DaiWai M. Olson, PhD RN FNCS, is Professor, University of Texas Southwestern, Dallas, TX.

Background: Post-intensive care syndrome (PICS) is a constellation of cognitive, physical, emotional, or psychiatric impairments that begins during or immediately after intensive care unit (ICU) hospitalization and persists beyond discharge. This executive review summarizes literature on PICS in the general ICU population and identifies gaps in the literature specific to the neurocritical care patient.

Method: The electronic databases PubMed, CINAHL, Cochrane Library, and Google Scholar were searched to identify any available literature on PICS. Read More

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http://dx.doi.org/10.1097/JNN.0000000000000438DOI Listing
April 2019
1 Read

Dark Play of Serious Games: Effectiveness and Features (G4HE2018).

Games Health J 2019 Apr 9. Epub 2019 Apr 9.

1 Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Objective: Choosing inappropriate or unethical actions in games is referred to as dark play. For a serious game on delirium for medical students, we aimed to investigate the potential differences between dark play and normal play on game effectiveness regarding abilities in advising care, learning motivation and engagement, and attitude toward delirious patients. Furthermore, we aimed to explore the use of different game features between the two types of play on empathy, self-efficacy, and consequences of care. Read More

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http://dx.doi.org/10.1089/g4h.2018.0126DOI Listing
April 2019
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Functional Outcomes After Hip Fracture in Independent Community-Dwelling Patients.

J Am Geriatr Soc 2019 Apr 9. Epub 2019 Apr 9.

Division of Geriatrics, University of Pennsylvania, Philadelphia, Pennsylvania.

Objectives: To determine predictors of new activities of daily living (ADLs) disability and worsened mobility disability and secondarily increased daily care hours received, in previously independent hip fracture patients.

Design: Retrospective cohort study.

Setting: Academic hospital with ambulatory follow-up. Read More

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http://dx.doi.org/10.1111/jgs.15870DOI Listing
April 2019
3 Reads

Frailty Identification and Care Pathway: An Interdisciplinary Approach to Care for Older Trauma Patients.

J Am Coll Surg 2019 Mar 21. Epub 2019 Mar 21.

Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA. Electronic address:

Background: Frailty is a well-established marker of poor outcomes in geriatric trauma patients. There are few interventions to improve outcomes in this growing population. Our goal was to determine if an interdisciplinary care pathway for frail trauma patients improved in-hospital mortality, complications, and 30-day readmissions. Read More

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http://dx.doi.org/10.1016/j.jamcollsurg.2019.02.052DOI Listing
March 2019
1 Read

Methadone-Related Delirium: Prevalence, Causes, and Outcomes.

J Nerv Ment Dis 2019 May;207(5):371-377

Minneapolis VA Medical Center.

Goals consist of determining 5-year prevalence and recurrence of methadone-related delirium (MRD), along with causes, treatments, and outcomes. Sample comprised 81 patients in methadone maintenance treatment. Criteria for MRD encompassed delirium with high methadone serum levels plus alleviation of delirium upon lowering methadone serum levels. Read More

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http://dx.doi.org/10.1097/NMD.0000000000000978DOI Listing
May 2019
1 Read
1.812 Impact Factor

Pharmacologic Considerations Surrounding Sedation, Delirium, and Sleep in Critically Ill Adults: A Narrative Review.

J Pharm Pract 2019 Apr 7:897190019840120. Epub 2019 Apr 7.

2 Department of Pharmacy, Surgical Intensive Care Unit, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, USA.

Introduction:: Agitation, delirium, and sleep dysfunction in the intensive care unit (ICU) are common occurrences that result in negative patient outcomes. With the recent publication of the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PAD-IS), several areas are of particular interest due to emerging literature or conflicting results of research.

Objective:: To highlight areas where emerging literature or variable study results exist and to provide the clinician with recommendations regarding patient management. Read More

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http://dx.doi.org/10.1177/0897190019840120DOI Listing
April 2019
2 Reads

Translation and Cultural Adaptation of Cornell Assessment of Pediatric Delirium to Spanish.

Pediatr Crit Care Med 2019 Apr;20(4):400-402

Pediatric Intensive Care Unit, Universitary Hospital, Salamanca, Spain Department of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, NY.

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http://dx.doi.org/10.1097/PCC.0000000000001853DOI Listing
April 2019
1 Read

The Perioperative Care of Older Patients.

Dtsch Arztebl Int 2019 Feb;116(5):63-69

Department of Intensive Care Medicine, Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf (UKE); Department of General, Visceral and Oncological Surgery Klinikum St. Georg, Leipzig; Clinic for Trauma and Reconstructive Surgery, BG Hospital, Tübingen; Department of General-, Visceral- and Vascular Surgery, Städtisches Klinikum Solingen gGmbH; Department of General Practice / Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE); Department of Anesthesiology and Intensive Care Medicine, Rotkreuzklinikum München.

Background: Elderly patients are a growing and vulnerable group with an elevated perioperative risk. Perioperative treatment pathways that take these patients' special risks and requirements into account are often not implemented in routine clinical practice.

Methods: This review is based on pertinent publications retrieved by a selective search in PubMed, the AWMF guideline database, and the Cochrane database for guidelines from Germany and abroad, meta-analyses, and Cochrane reviews. Read More

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http://dx.doi.org/10.3238/arztebl.2019.0063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444041PMC
February 2019
4 Reads
3.608 Impact Factor

Perioperative Dexmedetomidine Reduces Delirium in Elderly Patients after Lung Cancer Surgery.

Psychiatr Danub 2019 Mar;31(1):95-101

Key Laboratory for Space Biosciences and Biotechnology, Institute of Special Environment Biophysics, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China.

Background: Delirium, which is one of the most disturbing postoperative complications in elderly patients, shows high morbidity in patients undergoing lung cancer surgery. Dexmedetomidine (DEX) is considered a potential prophylactic agent for preventing patients' delirium after lung cancer surgery.

Subjects And Methods: Medical records of lung cancer patients over 65 years old with radical pulmonary resection at Henan Provincial People's Hospital from January 2015 to December 2017, China, were evaluated. Read More

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http://dx.doi.org/10.24869/psyd.2019.95DOI Listing
March 2019
2 Reads
0.653 Impact Factor

Effects of dexmedetomidine on delirium and mortality during sedation in ICU patients: a systematic review and meta-analysis protocol.

BMJ Open 2019 Apr 3;9(4):e025850. Epub 2019 Apr 3.

Department of Anesthesiology, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China.

Introduction: Delirium is very common in patients admitted to intensive care unit (ICU), and may worsen survival in these patients. Several meta-analyses have evaluated the antidelirium effects of dexmedetomidine in ICU patients, but their findings were inconsistent. Recently, several large multicentre randomised clinical trials (RCTs) were published, but they have not yet to be included in any meta-analysis. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025850DOI Listing
April 2019
3 Reads

Qualitative descriptive study to explore nurses' perceptions and experience on pain, agitation and delirium management in a community intensive care unit.

BMJ Open 2019 Apr 4;9(4):e024328. Epub 2019 Apr 4.

Community Health Sciences, Brock University, St. Catherines, Ontario, Canada.

Objectives: The purpose of this study was to explore the experiences, beliefs and perceptions of intensive care unit (ICU) nurses on the management of pain, agitation and delirium (PAD) in critically ill patients.

Design: A qualitative descriptive study.

Setting: This study took place in a community hospital ICU located in a medium size Canadian city. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024328DOI Listing
April 2019
2 Reads

Massive pulmonary embolism presenting initially as acute psychosis.

BMJ Case Rep 2019 Apr 3;12(4). Epub 2019 Apr 3.

Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.

This is a case of a 68-year-old man with Parkinson's disease who was admitted in the psychiatry floor for new-onset aggressive behaviour and hallucinations. On the third day of hospitalisation, he suddenly developed dyspnoea followed by an ECG showing atrial fibrillation with rapid ventricular response. A few seconds later, he went into cardiac arrest; he was resuscitated after multiple rounds of Advanced Cardiovascular Life Support. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2017-22201
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http://dx.doi.org/10.1136/bcr-2017-222018DOI Listing
April 2019
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Home Palliative Sedation Using Phenobarbital Suppositories: Time to Death, Patient Characteristics, and Administration Protocol.

Am J Hosp Palliat Care 2019 Apr 4:1049909119839695. Epub 2019 Apr 4.

1 Hospice of Central New York, Liverpool, NY, USA.

Background:: Most people in the United States and other countries cite their preferred location of death as their homes. However, intractable symptoms sometimes require hospitalization, especially if significant sedation becomes necessary. For over a decade, Hospice of Central New York has been using compounded phenobarbital suppositories with individuals in whom adequate sedation has not been achieved using sufficient doses of antipsychotics or benzodiazepines but prefer to remain in their homes. Read More

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http://dx.doi.org/10.1177/1049909119839695DOI Listing
April 2019
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A Quality Improvement Project to Increase Adherence to a Pain, Agitation, and Delirium Protocol in the Intensive Care Unit.

Dimens Crit Care Nurs 2019 May/Jun;38(3):174-181

Wendy Yan, DNP, CRNA, is a Nurse Anesthetist at Duke Regional Hospital. Brett T. Morgan, DNP, CRNA, is Director of the Nurse Anesthesia Program and an assistant professor at Duke University School of Nursing. Peter Berry, MSN, RN, CNL, CCRN, is nurse manager at the intensive care unit of Duke Raleigh Hospital. Mary K. Matthys, BSN, RN, CCRN, is clinical lead at the intensive care unit of Duke Raleigh Hospital. Julie A. Thompson, PhD, is a research associate and a statistical consultant at Duke University School of Nursing. Benjamin A. Smallheer, PhD, RN, ACNP-BC, FNP-BC, CCRN, CNE, is lead faculty of the Adult-Gerontology Acute Care Nurse Practitioner Program at Duke University School of Nursing. He actively practices within the Critical Care Setting at Duke Raleigh Hospital and has expertise in Pulmonary Critical Care. His current areas of research interest are the care of the aging critical care population, the implementation of innovative educational strategies to prepare Nurse Practitioner students for entry to practice, and gender-associated incivility experienced by male nursing students in the academic environment.

Background: In recent years, the incidence of delirium has grown to epidemic proportions in the intensive care setting with up to 80% of mechanically ventilated patients being affected. This can lead to adverse patient outcomes such as increased lengths of hospital stay, increased mortality rates, and increased long-term cognitive impairment.

Objectives: The objective of this project is to determine whether a quality improvement project can increase adherence to an existing pain, agitation, and delirium (PAD) protocol for enhanced patient outcomes. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000353DOI Listing
April 2019
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Early corticosteroid treatment for postoperative acute lung injury after lung cancer surgery.

Ther Adv Respir Dis 2019 Jan-Dec;13:1753466619840256

Division of Pulmonary and Critical Care Medicine, Department of Medicine and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea.

Background: Acute lung injury (ALI) is the most serious pulmonary complication after lung resection. Although the beneficial effects of low-dose corticosteroids have been demonstrated in patients with postoperative ALI, there are limited data on optimal corticosteroid treatment.

Methods: We retrospectively analyzed 58 patients who were diagnosed with ALI among 7593 patients who underwent lung cancer surgery between January 2009 and December 2016. Read More

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http://dx.doi.org/10.1177/1753466619840256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454659PMC
April 2019
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Measuring the distress related to delirium in older surgical patients and their Relatives.

Int J Geriatr Psychiatry 2019 Apr 4. Epub 2019 Apr 4.

Department of Health and Ageing, Guy's and St Thomas' NHS Foundation Trust, London.

Objective: Delirium is a common postoperative complication with implications on morbidity and mortality. Less is known about the psychological impact of delirium in patients and relatives. This study aimed to; 1. Read More

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http://dx.doi.org/10.1002/gps.5110DOI Listing
April 2019
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Benzodiazepines and/or neuroleptics for the treatment of delirium in palliative care?-a critical appraisal of recent randomized controlled trials.

Ann Palliat Med 2019 Mar 26. Epub 2019 Mar 26.

Department of Geriatric Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland; Department of Geriatrics and Aging Research, Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland.

Delirium is a frequent condition in patients in a palliative care situation and most often associated with substantial burden or even danger for the persons concerned as well as caregivers and health-care-professionals. Despite the lack of randomized-controlled-trials (RCTs) benzodiazepines and neuroleptic agents are used extensively in palliative care for the pharmacological management of delirium. A focused review for RCTs assessing pharmacotherapy with benzodiazepines and neuroleptics for the treatment of delirium in patients treated in a palliative care or hospice setting published in 2017 was performed in PubMed. Read More

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http://dx.doi.org/10.21037/apm.2019.03.06DOI Listing
March 2019
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Predictive Factors of Postoperative Delirium in Patients After Pancreaticoduodenectomy.

J Gastrointest Surg 2019 Apr 2. Epub 2019 Apr 2.

Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan.

Background: Postoperative delirium is a common serious complication after various types of surgery. However, the incidence and predictive factors associated with delirium after pancreaticoduodenectomy (PD) have not been investigated. Thus, this study aimed to investigate the incidence and predictive factors of postoperative delirium in patients who underwent PD. Read More

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http://dx.doi.org/10.1007/s11605-019-04212-1DOI Listing
April 2019
6 Reads