1,813 results match your criteria development delirium

Metabolic disturbance affects postoperative cognitive function in patients undergoing cardiopulmonary bypass.

Neurol Sci 2021 May 10. Epub 2021 May 10.

Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Objectives: Postoperative delirium is a common neuropsychiatric syndrome after coronary artery bypass grafting (CABG). We aimed to assess and compare clinical outcomes of CABG patients with delirium with a specific focus on the blood biochemical parameters.

Methods: This investigation was carried out on the 90 eligible patients undergoing CABG. Read More

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ED-DEL: Development of a change package and toolkit for delirium in the emergency department.

J Am Coll Emerg Physicians Open 2021 Apr 29;2(2):e12421. Epub 2021 Apr 29.

Aging Brain Center Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts USA.

Delirium is a common and deadly problem in the emergency department affecting up to 30% of older adult patients. The 2013 Geriatric Emergency Department guidelines were developed to address the unique needs of the growing older population and identified delirium as a high priority area. The emergency department (ED) environment presents unique challenges for the identification and management of delirium, including patient crowding, time pressures, competing priorities, variable patient acuity, and limitations in available patient information. Read More

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Orthogeriatric co-management reduces incidence of delirium in hip fracture patients.

Osteoporos Int 2021 May 8. Epub 2021 May 8.

Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.

Hip fracture patients often display an acute confusional state (delirium) which is associated with worse outcomes. In this observational study, we found that co-management of hip fracture patients by a multidisciplinary team including a geriatrician and an orthopaedic surgeon could reduce the incidence of delirium.

Introduction: Delirium after hip fracture is common and is associated with negative outcomes. Read More

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Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis.

Age Ageing 2021 May;50(3):733-743

School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.

Objective: Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 'A's Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Read More

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Development of a short-form Swedish version of the Montreal Cognitive Assessment (s-MoCA-SWE): protocol for a cross-sectional study.

BMJ Open 2021 May 3;11(5):e049035. Epub 2021 May 3.

Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Introduction: Short forms of the Montreal Cognitive Assessment (MoCA) have allowed quick cognitive screening. However, none of the available short forms has been created or validated in a Swedish sample of patients with stroke.The aim is to develop a short-form Swedish version of the MoCA (s-MoCA-SWE) in a sample of patients with acute and subacute stroke. Read More

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COVID-19 and Alzheimer's disease: how one crisis worsens the other.

Transl Neurodegener 2021 04 30;10(1):15. Epub 2021 Apr 30.

Center for Translational Neurodegeneration and Regenerative Therapy, Tenth People's Hospital of Tongji University, Shanghai, 200072, China.

Alzheimer's disease (AD) has emerged as a key comorbidity of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The morbidity and mortality of COVID-19 are elevated in AD due to multiple pathological changes in AD patients such as the excessive expression of viral receptor angiotensin converting enzyme 2 and pro-inflammatory molecules, various AD complications including diabetes, lifestyle alterations in AD, and drug-drug interactions. Meanwhile, COVID-19 has also been reported to cause various neurologic symptoms including cognitive impairment that may ultimately result in AD, probably through the invasion of SARS-CoV-2 into the central nervous system, COVID-19-induced inflammation, long-term hospitalization and delirium, and post-COVID-19 syndrome. 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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Hospital-treated deliberate self-poisoning patients: Drug-induced delirium and clinical outcomes.

Aust N Z J Psychiatry 2021 May 2:48674211009608. Epub 2021 May 2.

Department of Consultation-Liaison Psychiatry, Calvary Mater Newcastle Hospital, Waratah, NSW, Australia.

Objective: Drug-induced delirium has been attributed to opioid, benzodiazepine, antipsychotic, antihistaminic and anticholinergic drug groups at therapeutic doses. Delirium also occurs in hospital-treated self-poisoning (at supra-therapeutic doses), although the causative drug classes are not well established and co-ingestion is common. We tested the magnitude and direction of association of five major drug groups with incident cases of delirium. Read More

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Development and Validation of a Clinical Prediction Model for Sleep Disorders in the ICU: A Retrospective Cohort Study.

Front Neurosci 2021 16;15:644845. Epub 2021 Apr 16.

The Third Central Clinical College of Tianjin Medical University, Tianjin, China.

Background: Sleep disorders, the serious challenges faced by the intensive care unit (ICU) patients are important issues that need urgent attention. Despite some efforts to reduce sleep disorders with common risk-factor controlling, unidentified risk factors remain.

Objectives: This study aimed to develop and validate a risk prediction model for sleep disorders in ICU adults. Read More

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Preoperative medication use and development of postoperative delirium and cognitive dysfunction.

Clin Transl Sci 2021 May 2. Epub 2021 May 2.

Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Postoperative delirium (POD) and postoperative (neuro-)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre-operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (www. Read More

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Perioperative dexmedetomidine administration to prevent delirium in adults after non-cardiac surgery: A systematic review and meta-analysis.

J Clin Anesth 2021 Apr 28;73:110308. Epub 2021 Apr 28.

Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, PR China. Electronic address:

Study Objective: To evaluate the efficacy of perioperative dexmedetomidine (DEX) administration for preventing delirium in adults after non-cardiac surgery.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).

Interventions: Perioperative administration of DEX to prevent delirium in adults following non-cardiac surgery. Read More

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Elevated Monocyte Chemoattractant Protein-1 as the Independent Risk Factor of Delirium after Cardiac Surgery. A Prospective Cohort Study.

J Clin Med 2021 Apr 9;10(8). Epub 2021 Apr 9.

Department of Cardiac Surgery, Medical University of Lodz, 92-213 Lodz, Poland.

Background: The pathogenesis of postoperative delirium is largely unknown. The primary objective of this study is to assess whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and high-sensitivity C-reactive protein (hsCRP) are associated with postoperative delirium in patients who have undergone cardiac surgery. The secondary objective is to investigate whether any association between raised inflammatory biomarkers levels and delirium is related to surgical and anesthetic procedures or mediated by pre-existing psychiatric conditions associated with raised pro-inflammatory markers levels. Read More

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Risk factors for delirium after vascular surgery: a systematic review and meta-analysis.

Ann Vasc Surg 2021 Apr 24. Epub 2021 Apr 24.

Department of Surgery, Division of Transplantation Surgery, University Medical Center Groningen, Groningen, The Netherlands.

Background: Vascular surgery is considered a risk factor for the development of postoperative delirium (POD). In this systematic review we provide a report on the incidence and risk-factors of POD after vascular surgery.

Methods: A systematic literature search was conducted using Pubmed with the MeSH terms and key words "delirium" or "confusion", "vascular surgery procedures" and "risk factors or "risk assessment". Read More

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Prophylaxis against covid-19: living systematic review and network meta-analysis.

BMJ 2021 04 26;373:n949. Epub 2021 Apr 26.

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Objective: To determine and compare the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19.

Design: Living systematic review and network meta-analysis.

Data Sources: World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature to 25 March 2021, and six additional Chinese databases to 20 February 2021. Read More

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Appropriate Use of High-Flow Nasal Oxygen in Hospitalized Patients for Initial or Postextubation Management of Acute Respiratory Failure: A Clinical Guideline From the American College of Physicians.

Ann Intern Med 2021 Apr 27. Epub 2021 Apr 27.

Portland VA Medical Center, Portland, Oregon (D.K.).

Description: The American College of Physicians (ACP) developed this guideline to provide clinical recommendations on the appropriate use of high-flow nasal oxygen (HFNO) in hospitalized patients for initial or postextubation management of acute respiratory failure. It is based on the best available evidence on the benefits and harms of HFNO, taken in the context of costs and patient values and preferences.

Methods: The ACP Clinical Guidelines Committee based these recommendations on a systematic review on the efficacy and safety of HFNO. Read More

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Postoperative Maladaptive Behavior, Preoperative Anxiety and Emergence Delirium in Children Undergone General Anesthesia: A Narrative Review.

Glob Pediatr Health 2021 7;8:2333794X211007975. Epub 2021 Apr 7.

Universiti Sains Malaysia, School of Medical Sciences, Kubang Kerian, Kelantan, Malaysia.

Over the years, the number of pediatric patients undergoing surgeries are increasing steadily. The types of surgery vary between elective to emergency with involvement of multidisciplinary teams. The development of day care surgery unit is expanding where the patients will only come to the hospital on the day of surgery and discharge home after such as satisfactory parameters achieved, minimal to no pain, minimal to no bleeding from surgical site and able to tolerate fluids. Read More

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The family in preventing delirium in the intensive care unit: Scoping review.

Enferm Intensiva 2021 Apr 19. Epub 2021 Apr 19.

Facultad de Enfermería, Universidad Nacional de Colombia, Bogotá D.C., Colombia.

Introduction: Delirium is cognitive impairment related to negative inpatient outcomes in the Intensive Care Unit (ICU), family interventions have been shown to be effective in reducing the incidence of this condition.

Objective: To identify strategies that include the family in the prevention of delirium in the adult intensive care unit that can be integrated into ABCDEF.

Inclusion Criteria: Studies describing actions and interventions involving caregivers and family members in the ICU for the prevention of delirium, conducted in the last five years, available in full text, in English and Spanish, Portuguese and in adults. Read More

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Bedside voluntary and evoked forces evaluation in intensive care unit patients: a narrative review.

Crit Care 2021 04 22;25(1):157. Epub 2021 Apr 22.

Institut NeuroMyoGène (INMG); CNRS 5310 - INSERM U1217 - UCBL1; Faculté de Médecine et de Pharmacie, 8 Avenue Rockefeller, 69008, Lyon, France.

Around one third of intensive care unit (ICU) patients will develop severe neuromuscular alterations, known as intensive care unit-acquired weakness (ICUAW), during their stay. The diagnosis of ICUAW is difficult and often delayed as a result of sedation or delirium. Indeed, the clinical evaluation of both Medical Research Council score and maximal voluntary force (e. Read More

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A scalable approach for developing clinical risk prediction applications in different hospitals.

J Biomed Inform 2021 Apr 20;118:103783. Epub 2021 Apr 20.

Dedalus HealthCare, Roderveldlaan 2, 2600 Antwerp, Belgium. Electronic address:

Objective: Machine learning (ML) algorithms are now widely used in predicting acute events for clinical applications. While most of such prediction applications are developed to predict the risk of a particular acute event at one hospital, few efforts have been made in extending the developed solutions to other events or to different hospitals. We provide a scalable solution to extend the process of clinical risk prediction model development of multiple diseases and their deployment in different Electronic Health Records (EHR) systems. Read More

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General anaesthesia in end-of-life care: extending the indications for anaesthesia beyond surgery.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

In this article, we describe an extension of general anaesthesia - beyond facilitating surgery - to the relief of suffering during dying. Some refractory symptoms at the end of life (pain, delirium, distress, dyspnoea) might be managed by analgesia, but in high doses, adverse effects (e.g. Read More

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The Impact of Earplugs and Eye Masks on Sleep Quality in Surgical ICU Patients at Risk for Frequent Awakenings.

Crit Care Med 2021 Apr 16. Epub 2021 Apr 16.

Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, TX. Department of Anesthesiology, University of California - Irvine, Orange, CA. University of Texas Southwestern Medical Center, Dallas, TX. Department of Biostatistics and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX.

Objectives: Sleep disturbances may contribute to the development of delirium, prolonged ICU stay, and increased mortality. There is conflicting data on the effectiveness of earplugs and eye masks for sleep promotion in the ICU. This study evaluates the impact of earplugs and eye masks on sleep quality in postoperative surgical ICU patients at risk for frequent awakenings. 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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Scopolamine promotes neuroinflammation and delirium-like neuropsychiatric disorder in mice.

Sci Rep 2021 Apr 16;11(1):8376. Epub 2021 Apr 16.

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Postoperative delirium is a common neuropsychiatric syndrome resulting a high postsurgical mortality rate and decline in postdischarge function. Extensive research has been performed on both human and animal delirium-like models due to their clinical significance, focusing on systematic inflammation and consequent neuroinflammation playing a key role in the pathogenesis of postoperative cognitive dysfunctions. Since animal models are widely utilized for pathophysiological study of neuropsychiatric disorders, this study aimed at examining the validity of the scopolamine-induced delirium-like mice model with respect to the neuroinflammatory hypothesis of delirium. Read More

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The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study.

BMC Geriatr 2021 04 15;21(1):249. Epub 2021 Apr 15.

School of Medicine, Tzu Chi University, Hualien, Taiwan.

Background: People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. 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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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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Neuropsychiatric Symptoms of COVID-19 Explained by SARS-CoV-2 Proteins' Mimicry of Human Protein Interactions.

Front Hum Neurosci 2021 23;15:656313. Epub 2021 Mar 23.

Research Center for Translational Medicine, Koç University, Istanbul, Turkey.

The first clinical symptoms focused on the presentation of coronavirus disease 2019 (COVID-19) have been respiratory failure, however, accumulating evidence also points to its presentation with neuropsychiatric symptoms, the exact mechanisms of which are not well known. By using a computational methodology, we aimed to explain the molecular paths of COVID-19 associated neuropsychiatric symptoms, based on the mimicry of the human protein interactions with SARS-CoV-2 proteins. Available 11 of the 29 SARS-CoV-2 proteins' structures have been extracted from Protein Data Bank. Read More

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Depression as a predictor of postoperative delirium after cardiac surgery: a systematic review and meta-analysis.

Interact Cardiovasc Thorac Surg 2021 Apr;32(3):371-379

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Objectives: Depression is common in patients with cardiac disease. The importance of preoperative depression for development of postoperative delirium (POD) following cardiac surgery is not well known. The aim is to provide a summary estimate of depression as a predictor of POD following cardiac surgery. Read More

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The effectiveness and tolerability of anti-seizure medication in alcohol withdrawal syndrome: a systematic review, meta-analysis and GRADE of the evidence.

Addiction 2021 Apr 6. Epub 2021 Apr 6.

National Addiction Centre and the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and the Maudsley NHS Foundation Trust, London, UK.

Background And Aims: Anti-seizure medications (ASMs) have been used historically as treatment options in alcohol withdrawal syndrome (AWS). In the past 10 years, there have been no large-scale meta-analyses comparing ASMs with placebo or the current AWS treatment standard, benzodiazepines. We aimed to evaluate the efficacy and tolerability of ASMs in AWS. Read More

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