1,098 results match your criteria delirium critically


Future lines of research on pain care, sedation, restraints and delirium in the critically ill patient.

Enferm Intensiva 2021 Apr-Jun;32(2):57-61

Enfermera, Organización Nacional de Trasplantes. Grupo de Investigación en Enfermería y Cuidados de Salud - Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA).

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Prospective Randomized Controlled Pilot Study of High-Intensity Lightbox Phototherapy to Prevent ICU-Acquired Delirium Incidence.

Cureus 2021 Apr 1;13(4):e14246. Epub 2021 Apr 1.

Pulmonary, Critical Care and Sleep Medicine Section, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA.

Background This study aimed to evaluate the role of disturbed circadian rhythm in potentiating intensive care unit (ICU)-acquired delirium.Previous studies have demonstrated bright light therapy (BLT) as an effective modality to improve sleeping patterns and cognitive function in non-critically ill patients. However, its benefit in the ICU has not been clearly established. Read More

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Dealing with missing delirium assessments in prospective clinical studies of the critically ill: a simulation study and reanalysis of two delirium studies.

BMC Med Res Methodol 2021 May 6;21(1):97. Epub 2021 May 6.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: In longitudinal critical care studies, researchers may be interested in summarizing an exposure over time and evaluating its association with a long-term outcome. For example, the number of days a patient has delirium (i.e. Read More

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Electroencephalography of mechanically ventilated patients at high risk of delirium.

Acta Neurol Scand 2021 May 5. Epub 2021 May 5.

Department of Intensive Care Medicine, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

Objective: Neurophysiological exploration of ICU delirium is limited. Here, we examined EEG characteristics of medical-surgical critically ill patients with new-onset altered consciousness state at high risk for ICU delirium.

Materials And Methods: Pre-planned analysis of non-neurological mechanically ventilated medical-surgical ICU subjects, who underwent a prospective multicenter randomized, controlled EEG study (NCT03129438, April 2017-November 2018). Read More

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Design of Clinical Trials Evaluating Sedation in Critically Ill Adults Undergoing Mechanical Ventilation: Recommendations From Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) Recommendation III.

Crit Care Med 2021 Apr 28. Epub 2021 Apr 28.

1 Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 2 University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 3School of Health Sciences, University of London, London, United Kingdom. 4 School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia. 5 Center of Healthy Aging, Self-Management, and Complex Care, The Ohio State University, College of Nursing, Columbus, OH. 6 Clear Consults, LLC, Hayward, WI. 7 Leslie Dan Faculty of Pharmacy, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. 8 Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD. 9 Departments of Anesthesiology and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. 10 School of Pharmacy, Northeastern University, Boston, MA 11 Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA. 12 Department of Anesthesia, University of Iowa, Iowa City, IA. 13 Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 14 Department of Anesthesiology, University of Utah, Salt Lake City, UT. 15 Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. 16 Intensive Care Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 17 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA. 18 Department of Medicine, Tufts University School of Medicine, Maine Medical Center, Portland, ME. 9 Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. 20 Division of Anesthesiology and CCM, Hadassah Medical Center, The Hebrew University School of Medicine, Jerusalem, Israel. 21 Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT. 22 Center for Humanizing Critical Care, Intermountain Medical Center, Murray, UT. 23 Department of Medicine, Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL. 24 Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA. 25 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD. 26 Department of Anesthesiology and the Critical Illness, Vanderbilt University Medical Center, Nashville, TN. 27 Department of Critical Care Services, Maine Medical Center, Portland, ME. 28 Department of Outcomes Research, Cleveland Clinic, Cleveland, OH. 29 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA. 30 Monash Health School of Clinical Sciences - Department of Intensive Care Medicine - Critical Care Research, Melbourne, VIC, Australia. 31 Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Campus Charité Mitte & Campus Virchow-Klinikum, Berlin, Germany. 32 Department of Anesthesiology, Columbia University Medical Center, New York, NY. 33 Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL. 34 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Objectives: Clinical trials evaluating the safety and effectiveness of sedative medication use in critically ill adults undergoing mechanical ventilation differ considerably in their methodological approach. This heterogeneity impedes the ability to compare results across studies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research Recommendations convened a meeting of multidisciplinary experts to develop recommendations for key methodologic elements of sedation trials in the ICU to help guide academic and industry clinical investigators. Read More

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The role of non-invasive brain oximetry in adult critically ill patients without primary brain injury.

Minerva Anestesiol 2021 May 3. Epub 2021 May 3.

Trauma and NeuroCritical Care Unit, Cambridge University Hospital, Cambridge, UK.

A primary objective in intensive care and perioperative settings is to promote an adequate supply and delivery of oxygen to tissues and organs, particularly to the brain. Cerebral near infrared spectroscopy (NIRS) is a non-invasive, continuous monitoring technique, that can be used to assess cerebral oxygenation. Using NIRS to monitor cerebral oximetry is not new, and has been in widespread use in neonates and cardiac surgery for decades. Read More

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Association of Delirium during Critical Illness With Mortality: Multicenter Prospective Cohort Study.

Anesth Analg 2021 Apr 30. Epub 2021 Apr 30.

Department of Anesthesiology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee.

Background: The temporal association of delirium during critical illness with mortality is unclear, along with the associations of hypoactive and hyperactive motoric subtypes of delirium with mortality. We aimed to evaluate the relationship of delirium during critical illness, including hypoactive and hyperactive motoric subtypes, with mortality in the hospital and after discharge up to 1 year.

Methods: We analyzed a prospective cohort study of adults with respiratory failure and/or shock admitted to university, community, and Veterans Affairs hospitals. Read More

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Current State of Analgesia and Sedation in the Pediatric Intensive Care Unit.

J Clin Med 2021 Apr 23;10(9). Epub 2021 Apr 23.

Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA.

Critically ill pediatric patients often require complex medical procedures as well as invasive testing and monitoring which tend to be painful and anxiety-provoking, necessitating the provision of analgesia and sedation to reduce stress response. Achieving the optimal combination of adequate analgesia and appropriate sedation can be quite challenging in a patient population with a wide spectrum of ages, sizes, and developmental stages. The added complexities of critical illness in the pediatric population such as evolving pathophysiology, impaired organ function, as well as altered pharmacodynamics and pharmacokinetics must be considered. Read More

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Mild to Severe Neurological Manifestations of COVID-19: Cases Reports.

Int J Environ Res Public Health 2021 04 1;18(7). Epub 2021 Apr 1.

School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, 41125 Modena, Italy.

The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. Read More

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Are dexmedetomidine and olanzapine suitable to control delirium in critically ill elderly patients? A retrospective cohort study.

Biomed Pharmacother 2021 Apr 26;139:111617. Epub 2021 Apr 26.

Neurology Ward, Dalian Municipal Central Hospital, Dalian 116033, China. Electronic address:

Background: The efficacy and safety of dexmedetomidine and olanzapine for delirium control in critically ill elderly patients without ventilation or surgery are not known.

Methods: The efficacy and safety of dexmedetomidine and olanzapine for controlling delirium were evaluated in a retrospective cohort of critically illness by assessing the sedation level, drug dose/duration, combination rate with other sedatives, adverse effects, intubation rate and prognosis.

Result: The maximum (1. Read More

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Accuracy of delirium assessments in critically ill children: A prospective, observational study during routine care.

Aust Crit Care 2021 May 21;34(3):226-234. Epub 2020 Oct 21.

Paediatric Critical Care Research Group, Centre for Children's Health Research, Brisbane, Australia; Paediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Australia.

Objectives: The objectives of this study was to explore the accuracy of the Cornell Assessment for Pediatric Delirium (CAP-D), Pediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU), and Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU) when implemented in routine care as delirium screening tools, and to assess patient characteristics and clinical variables that may affect their validity.

Design: This is a prospective observational study.

Setting: The study was conducted in a 36-bed, mixed paediatric intensive care unit (PICU) at an Australian tertiary hospital. Read More

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Changes in Sedation Practices in Association with Delirium Screening in Infants After Cardiopulmonary Bypass.

Pediatr Cardiol 2021 Apr 23. Epub 2021 Apr 23.

Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, USA.

Sedation in the cardiac intensive care unit (CICU) is necessary to keep critically ill infants safe and comfortable. However, long-term use of sedatives may be associated with adverse neurodevelopmental outcomes. We aimed to examine sedation practices in the CICU after the implementation of the Cornell Assessment of Pediatric Delirium (CAPD). Read More

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Nursing intervention to prevent delirium in critically ill adults.

Rev Esc Enferm USP 2021 16;55:e03685. Epub 2021 Apr 16.

Los Comuneros Hospital Universitario de Bucaramanga, Bucaramanga, Santander, Colombia.

Objective: To determine the effectiveness of a nursing intervention for delirium prevention in critically ill patients.

Method: A quasi-experimental study was conducted with a non-equivalent control group and with evaluation before and after the intervention. 157 Patients were part of the intervention group and 134 of the control group. Read More

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A Core Outcome Set for Research Evaluating Interventions to Prevent and/or Treat Delirium in Critically Ill Adults: An International Consensus Study (Del-COrS).

Crit Care Med 2021 Apr 19. Epub 2021 Apr 19.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada. Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada. Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. College of Pharmacy, Purdue University, West Lafayette, IN. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland Inaugural Research Chair in Geriatric Emergency Medicine, Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada. St Michael's Hospital and Li Ka Shing Research Institute, Toronto, ON, Canada. School of Pharmacy, Northeastern University, Boston, MA. Wellcome-Wolfson Institute of Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland. School of Medicine, Johns Hopkins University, Baltimore, MD. Hull York Medical School, University of York, York, United Kingdom. Watford General Hospital, Watford, United Kingdom.

Objectives: Delirium in critically ill adults is highly prevalent and has multiple negative consequences. To-date, trials of interventions to prevent or treat delirium report heterogenous outcomes. To develop international consensus among key stakeholders for a core outcome set for future trials of interventions to prevent and/or treat delirium in critically ill adults. Read More

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Incidence and factors associated with delirium in children in a single pediatric intensive care unit in Brazil.

J Pediatr Nurs 2021 Apr 13. Epub 2021 Apr 13.

Pediatric Nursing Department, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil. Electronic address:

Purpose: To identify the incidence of delirium in a Pediatric Intensive Care Unit (PICU); to determine the factors associated with the occurrence of delirium and the agreement between two scales used for detection of pediatric delirium in critically ill children.

Designs And Method: Descriptive longitudinal study carried out in a PICU. The sample consisted of 65 critically ill children admitted to the PICU, with more than 24 h of hospitalization, excluding children with neurological or cognitive impairment, hearing and visual impairment, chronic encephalopathy and declining consent to participate in the study. Read More

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Association Between Incident Delirium Treatment With Haloperidol and Mortality in Critically Ill Adults.

Crit Care Med 2021 Apr 5. Epub 2021 Apr 5.

1 Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA. 2 Department of Intensive Care, Radboud Institute for Health Science, Radboud University Medical Center, Nijmegen, NL. 3 Department of Health Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA.

Objectives: Haloperidol is commonly administered in the ICU to reduce the burden of delirium and its related symptoms despite no clear evidence showing haloperidol helps to resolve delirium or improve survival. We evaluated the association between haloperidol, when used to treat incident ICU delirium and its symptoms, and mortality.

Design: Post hoc cohort analysis of a randomized, double-blind, placebo-controlled, delirium prevention trial. Read More

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Barriers and enablers to the development and implementation of early mobility programs for children in the pediatric intensive care unit: a scoping review protocol.

JBI Evid Synth 2021 Apr 12. Epub 2021 Apr 12.

Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada School of Physiotherapy, Dalhousie University, Halifax, NS, Canada School of Nursing, Dalhousie University, Halifax, NS, Canada Aligning Health Needs and Evidence for Transformation Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada WK Kellogg Health Science Library, Dalhousie University, Halifax, NS, Canada Professional Practice & Complex Pain, IWK Health Centre, Halifax, NS, Canada Department of Critical Care, Dalhousie University, Halifax, NS, Canada Department of Pediatrics, Western University, ON, Canada Lawson Health Research Institute, London, ON, Canada Children's Health Research Institute, London, ON, Canada.

Objective: The objective of this scoping review is to gather and map the current literature associated with barriers and enablers related to the development and implementation of an early mobility program in pediatric intensive care units.

Introduction: As care for critically ill patients has evolved, strategies to optimize patient outcomes and reduce the side effects of treatment have become a rising priority for clinicians, patients, and their families. Early mobilization of patients with critical illness is the only evidence-based intervention that decreases intensive care unit-acquired weakness; it may also minimize intensive care unit-acquired delirium. Read More

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Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up.

J Neuropsychiatry Clin Neurosci 2021 Apr 12. Epub 2021 Apr 12.

Grupo de Investigación en Psiquiatría de Enlace, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia (Velásquez-Tirado, Franco); Clinica Universitaria Bolivariana, Medellín, Colombia (Velásquez-Tirado); and the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Trzepacz).

Objective: The investigators aimed to describe delirium etiologies and clinical characteristics, as well as the relationship between COVID-19 and delirium severities, at baseline and follow-up after delirium improvement among patients with SARS-CoV-2 infection.

Methods: A longitudinal study of 20 consecutive critically ill, delirious COVID-19 inpatients, assessed with the Charlson Comorbidity Index-Short Form (CCI-SF), COVID-19 Clinical Severity Scale (CCSS), Delirium Etiology Checklist, Delirium Motor Subtype Scale-4, and Delirium Diagnostic Tool-Provisional (DDT-Pro), was conducted. Correlational analysis of delirium severity (DDT-Pro) with each measure of clinical severity (CCI-SF and CCSS) and comparison of baseline DDT-Pro scores between patients who were living and those who were deceased at follow-up were conducted. Read More

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Associations between caregiver-detected delirium and symptoms of depression and anxiety in family caregivers of critically ill patients: a cross-sectional study.

BMC Psychiatry 2021 04 9;21(1):187. Epub 2021 Apr 9.

Department of Critical Care Medicine, Department of Community Health Sciences, Department of Psychiatry, and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada.

Background: Witnessing delirium can be distressing for family caregivers (i.e., relatives or friends) of critically ill patients. Read More

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Opioid Use Increases the Risk of Delirium in Critically Ill Adults Independently of Pain.

Am J Respir Crit Care Med 2021 Apr 9. Epub 2021 Apr 9.

University Medical Center, Utrecht University, Department of Intensive Care Medicine, Utrecht, Netherlands.

Rationale: It is unclear whether opioid use increases the risk of ICU delirium. Prior studies have not accounted for confounding including daily severity of illness, pain and competing events that may preclude delirium detection.

Objectives: To evaluate the association between ICU opioid exposure, opioid dose, and delirium occurrence. Read More

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Long-Term Outcomes in Intensive Care Unit Patients with Delirium: A Population-Based Cohort Study.

Am J Respir Crit Care Med 2021 Apr 6. Epub 2021 Apr 6.

University of Calgary, 2129, Calgary, Alberta, Canada.

Rationale: Delirium is common in the intensive care unit (ICU) and portends worse ICU and hospital outcomes. The effect of delirium in the ICU on post-hospital discharge mortality and health resource utilization is less well known.

Objectives: To estimate mortality and health resource utilization 2. Read More

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Case Report: Administration of Amniotic Fluid-Derived Nanoparticles in Three Severely Ill COVID-19 Patients.

Front Med (Lausanne) 2021 17;8:583842. Epub 2021 Mar 17.

Organicell Regenerative Medicine, Inc., Miami, FL, United States.

A human coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak worldwide. There is an urgent need to develop new interventions to suppress the excessive immune response, protect alveolar function, and repair lung and systemic organ damage. Zofin (previously known as Organicell Flow) is a novel therapeutic that is derived from the soluble and nanoparticle fraction (extracellular vesicles and exosomes) of human amniotic fluid. Read More

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Characterization of Nocturnal Neuroactive Medication Use and Related Sleep Documentation in Critically Ill Adults.

Crit Care Explor 2021 Mar 15;3(3):e0367. Epub 2021 Mar 15.

Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA.

We retrospectively characterized scheduled, newly initiated, nocturnal neuroactive medication use, and related clinician documentation, in a cohort of consecutive adults admitted greater than or equal to 24 hours to seven different medical/surgical ICUs at two academic centers who had not received a scheduled nocturnal neuroactive medication prior to admission, over a 5-month period (April 1, 2017, to August 31, 2017). A total of 207 different newly initiated, scheduled nocturnal neuroactive medication orders were written (melatonin agonist 101 [48.8%], antipsychotic 80 [38. Read More

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The effect of a quality improvement intervention on sleep and delirium in critically ill patients in a surgical intensive care unit.

Chest 2021 Mar 24. Epub 2021 Mar 24.

Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego School of Medicine, La Jolla, CA, USA.

Background: Delirium is a deleterious condition affecting up to 60% of patients in the surgical intensive care unit (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients.

Research Question: What is the effect on delirium and sleep quality of a multicomponent non-pharmacological intervention aimed at improving sleep-wake disruption in patients in the SICU setting?

Study Design And Methods: Using a staggered pre-post design, we implemented a quality improvement intervention in two SICUs (general surgery/trauma and cardiovascular) in an academic medical center. Read More

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Quantitative Electroencephalographic Markers of Delirium in the Pediatric Intensive Care Unit: Insights From a Heterogenous Convenience Sample.

J Neuropsychiatry Clin Neurosci 2021 Mar 24:appineuropsych20070184. Epub 2021 Mar 24.

Departments of Rehabilitation Medicine (Shah, Lowder), Pediatrics (Traube), and Population Health Sciences (Mauer, Gerber), Cornell University Joan and Sanford I Weill Medical College, New York; Clinical and Translational Science Center, Cornell University Joan and Sanford I Weill Medical College, New York (Gautam); Department of Pediatrics, New York-Presbyterian Hospital, New York (Carullo, Parlatore, Traube); Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York (Shah, Schiff); Department of Neurology, Weill Cornell Medicine, New York (Schiff); and Rockefeller University Hospital, New York (Schiff).

Objective: Little is known about the underlying neurophysiology of pediatric delirium. In adult patients, the sensitivity of EEG to clinical symptoms of delirium has been noted, with a slowing of background activity (alpha) and an increase in slow-wave activity (delta-theta). In this pilot study, the authors extended this investigation to a pediatric cohort. Read More

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Does rocking motion calm delirious patients in ICU? A multicentre randomised clinical trial protocol (RockingICU).

Acta Anaesthesiol Scand 2021 Mar 18. Epub 2021 Mar 18.

Department of Intensive Care, Rigshospitalet University Hospital, Copenhagen, Denmark.

Background: Rocking chair therapy has been explored in patients with dementia to promote the feeling of relaxation, but not in Intensive Care Unit (ICU) patients with delirium.

Aim: The aim is to investigate the effect of a chair with or without rocking motion on the duration of delirium and intensity of agitation in critically ill patients admitted to the ICU.

Design: This is an investigator-initiated pragmatic, multicentre, parallel-grouped, centrally randomised, stratified, data analyst-blinded trial. Read More

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[Progress in pathophysiology and integrated traditional Chinese and Western medicine of post-intensive care syndrome].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Feb;33(2):252-256

Department of Critical Care, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, China.

With the continuous improvement of treatment ability in intensive care unit (ICU), many critically ill and complex patients have survived due to the development of technology. However, most of them suffer from the psychological and physiological problems of post-intensive care syndrome (PICS). Therefore, the early identification and prevention of PICS is particularly critical. Read More

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February 2021

Evaluation of Delirium in Critically Ill Patients Prescribed Melatonin or Ramelteon.

Ann Pharmacother 2021 Mar 14:10600280211002054. Epub 2021 Mar 14.

Brigham and Women's Hospital, Boston, MA, USA.

Background: An impaired sleep-wake cycle may be one factor that affects the development of delirium in critically ill patients. Several small studies suggest that exogenous melatonin or ramelteon may decrease the incidence and/or duration of delirium.

Objective: To compare the effect of prophylactic administration of melatonin, ramelteon, or no melatonin receptor agonist on the development of delirium in the intensive care unit (ICU). Read More

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Association between physical restraint requirement and unfavorable neurologic outcomes in subarachnoid hemorrhage.

J Intensive Care 2021 Mar 12;9(1):24. Epub 2021 Mar 12.

Emergency Medical Center, Kagawa University Hospital, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.

Background: Physical restraint has been commonly indicated to patients with brain dysfunction in neurocritical care. The effect of physical restraints on outcomes of critically ill adults remains controversial as no randomized controlled trials have compared its safety and efficacy, and the association between physical restraint requirement and neurological outcome in patients with subarachnoid hemorrhage (SAH) has not been fully examined. The aim of this study was to examine the association between physical restraint requirement and neurological outcomes in patients with SAH. Read More

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Years of Life Lost (YLL) Due to Substance Abuse in Iran, in 2014-2017: Global Burden of Disease 2010 Method.

Iran J Public Health 2020 Nov;49(11):2170-2178

Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults.

Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016. Read More

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November 2020