65 results match your criteria dexamethasone delirium

Steroids to reduce the impact on delirium (STRIDE): a double-blind, randomised, placebo-controlled feasibility trial of pre-operative dexamethasone in people with hip fracture.

Anaesthesia 2021 Apr 25. Epub 2021 Apr 25.

Department of Geriatric Medicine, University of Auckland and Waitematā DHB, Auckland, New Zealand.

Neuro-inflammation may be important in the pathogenesis of postoperative delirium following hip fracture surgery. Studies have suggested a potential role for steroids in reducing postoperative delirium; however, the potential efficacy and safety of pre-operative high-dose dexamethasone in this specific population is largely unknown. Conducting such a study could be challenging, considering the multidisciplinary team involvement and the emergency nature of the surgery. Read More

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Preventing delirium after hip fracture surgery.

Anaesthesia 2021 Apr 4. Epub 2021 Apr 4.

Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

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Association between Dexamethasone and Delirium in Critically Ill Patients: A Retrospective Cohort Study of a Large Clinical Database.

J Surg Res 2021 Feb 24;263:89-101. Epub 2021 Feb 24.

Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. Electronic address:

Background: Delirium is a common complication in intensive care unit (ICU) patients, and it can significantly increase the length of hospital stay and cost. Dexamethasone is widely used in various inflammatory diseases and must be used with caution in critically ill patients. Previous studies have shown that the effect of corticosteroid use on the development of delirium in critically ill patients is still controversial, and there is inconclusive conclusion about the effect of dexamethasone on delirium in such patients. Read More

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February 2021

Glucocorticoids and the Brain after Critical Illness.

Endocrinology 2021 03;162(3)

Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA.

Treatment for critical illness typically focuses on a patient's short-term physical recovery; however, recent work has broadened our understanding of the long-term implications of illness and treatment strategies. In particular, survivors of critical illness have significantly elevated risk of developing lasting cognitive impairment and psychiatric disorders. In this review, we examine the role of endogenous and exogenous glucocorticoids in neuropsychiatric outcomes following critical illness. Read More

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Association of Dexamethasone with Shunt Requirement, Early Disability, and Medical Complications in Aneurysmal Subarachnoid Hemorrhage.

Neurocrit Care 2020 Aug 26. Epub 2020 Aug 26.

Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.

Background And Purpose: Current guidelines do not support the routine use of corticosteroids in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, corticosteroids use in aSAH has been practiced at some centers by convention. The aim of the study was to determine the incidence of hydrocephalus requiring ventriculoperitoneal shunt (VPS) placement as well as functional outcome on discharge and adverse events attributed to corticosteroids in patients with aSAH treated with different dexamethasone (DXM) treatment schemes. Read More

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High dose dexamethasone treatment for Acute Respiratory Distress Syndrome secondary to COVID-19: a structured summary of a study protocol for a randomised controlled trial.

Trials 2020 Aug 26;21(1):743. Epub 2020 Aug 26.

Intensive Care Unit, CEMIC, Buenos Aires, Argentina.

Objectives: The aim of this study is to explore the effectiveness and safety of high dose dexamethasone treatment for Acute Respiratory Distress Syndrome secondary to SARS-Cov-2 pneumonia.

Trial Design: Multicentre, randomized clinical trial, controlled, open label, parallel group, to evaluate the effectiveness and safety of high dose dexamethasone in adult patients with confirmed COVID-19, with Acute Respiratory Distress Syndrome.

Participants: We will include patients with SARS-Cov-2 pneumonia who develop acute respiratory distress syndrome, in several intensive care units (ICU) in Buenos Aires, Argentina (CEMIC, Clinica Bazterrica, Sanatorio Sagrado Corazon) Inclusion criteria: Men and women, age ≥ 18 years old. Read More

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Fatal high-grade skull osteosarcoma 30 years following radiotherapy for Cushing's disease.

Endocrinol Diabetes Metab Case Rep 2020 Jul 5;2020. Epub 2020 Jul 5.

Department of Endocrinology and Diabetes, Blacktown Hospital, Sydney, Australia.

Summary: Cushing's disease is a rare disorder characterised by excessive cortisol production as a consequence of a corticotroph pituitary tumour. While the primary treatment is surgical resection, post-operative radiation therapy may be used in cases of ongoing inadequate hormonal control or residual or progressive structural disease. Despite improved outcomes, radiotherapy for pituitary tumours is associated with hypopituitarism, visual deficits and, rarely, secondary malignancies. Read More

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Decitabine and Vorinostat with Chemotherapy in Relapsed Pediatric Acute Lymphoblastic Leukemia: A TACL Pilot Study.

Clin Cancer Res 2020 05 22;26(10):2297-2307. Epub 2020 Jan 22.

Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.

Purpose: Treatment failure from drug resistance is the primary reason for relapse in acute lymphoblastic leukemia (ALL). Improving outcomes by targeting mechanisms of drug resistance is a potential solution.

Patients And Methods: We report results investigating the epigenetic modulators decitabine and vorinostat with vincristine, dexamethasone, mitoxantrone, and PEG-asparaginase for pediatric patients with relapsed or refractory B-cell ALL (B-ALL). Read More

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Effects of dexamethasone on post-operative cognitive dysfunction and delirium in adults following general anaesthesia: a meta-analysis of randomised controlled trials.

BMC Anesthesiol 2019 06 29;19(1):113. Epub 2019 Jun 29.

Department of Anesthesiology, Jilin University Second Hospital, No. 218 Ziqiang street, Changchun, Jilin, 130021, People's Republic of China.

Background: Several studies have investigated the effects of dexamethasone on post-operative cognitive dysfunction (POCD) or post-operative delirium (POD); however, their conclusions have been inconsistent. Thus, we conducted a meta-analysis to determine the effects of dexamethasone on POCD and POD in adults following general anaesthesia.

Methods: The Cochrane Central Register of Controlled Trials (2018, Issue 11 of 12) in the Cochrane Library (searched 17 November 2018), MEDLINE OvidSP (1946 to 16 November 2018) and Embase OvidSP (1974 to 16 November 2018) were searched for randomised controlled trials that evaluated the incidence of POCD and POD following dexamethasone administration in adults (age ≥ 18 years) under general anaesthesia. Read More

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Dexamethasone Reduces Postoperative Nausea in Pediatric Upper Endoscopy With Deep Sedation: A Randomized Controlled Trial.

J Pediatr Gastroenterol Nutr 2019 09;69(3):281-286

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: We aimed to evaluate the effect of a single dose of preoperative dexamethasone on postoperative nausea and vomiting (PONV), a frequent complication and a major cause of delayed recovery in pediatric upper gastrointestinal endoscopy (UGIE) under sedation.

Methods: In this double-blind randomized controlled study, 98 children aged 2 to 14, with American Society of Anesthesiologists status I to II, and undergoing elective UGIE with deep sedation were included and randomly assigned to 2 groups. Preoperatively, after anesthesia induction with sodium thiopental and maintenance with sevoflurane, patients in the intervention (n = 49) and control (n = 49) groups, respectively received 0. Read More

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September 2019

Dexamethasone as Abortive Treatment for Refractory Seizures or Status Epilepticus in the Inpatient Setting.

J Investig Med High Impact Case Rep 2019 Jan-Dec;7:2324709619848816

1 Louisiana State University Health Sciences Center, New Orleans, LA, USA.

Refractory seizures or status epilepticus (RS/SE) continues to be a challenge in the inpatient setting. Failure to abort a seizure with antiepileptic drugs (AEDs) may lead to intubation and treatment with general anesthesia exposing patients to complications, extending hospitalization, and increasing the cost of care. Studies have shown a key role of inflammatory mediators in seizure generation and termination. Read More

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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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Pharmacologic prevention of postoperative delirium after on-pump cardiac surgery: A meta-analysis of randomized trials.

Medicine (Baltimore) 2018 Oct;97(43):e12771

Department of Substance-Related Disorders, Division of Psychiatry, Hefei No.4 People's Hospital, Anhui Mental Health Center.

Background: Postoperative delirium is a prevalent and disabling mental disorder in patients undergoing on-pump cardiac surgery. There is some evidence that the use of pharmacological interventions may reduce the risk of developing of postoperative delirium. Therefore, the aim of this meta-analysis was to determine the effect of pharmacologic agents for the prevention postoperative delirium after cardiac surgery. Read More

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October 2018

Identifying Patterns of Delirium in Hospitalized Patients on Dexamethasone Using a Chart Abstraction Tool.

J Pain Palliat Care Pharmacother 2018 Mar 11;32(1):30-36. Epub 2018 Sep 11.

Delirium is a neuropsychiatric syndrome that can occur in hospitalized patients, including in palliative care settings. The aim of this study is to describe patterns of delirium in patients receiving dexamethasone at the request of an inpatient palliative consultation team by using a modified chart abstraction tool. This retrospective study analyzed patterns of delirium development in adult hospitalized patients receiving opioids for cancer-related pain and initiated on dexamethasone with recommendation from the palliative care team. Read More

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Reply to: dexamethasone and postoperative cognitive decline.

Eur J Anaesthesiol 2018 08;35(8):635-636

From the Clinical Department of Anaesthesiology and Intensive Care, University Hospital of Split (SG, NK), Department of Psychology, Faculty of Humanities and Social Sciences (GK) and Department of Anaesthesiology and Intensive Medicine, School of Medicine, University of Split, Split, Croatia (NK).

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Dexamethasone and postoperative cognitive decline.

Eur J Anaesthesiol 2018 08;35(8):634-635

From the Department of Anesthesiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA (MCK, LJC-A).

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Acute transient cognitive dysfunction and acute brain injury induced by systemic inflammation occur by dissociable IL-1-dependent mechanisms.

Mol Psychiatry 2019 10 6;24(10):1533-1548. Epub 2018 Jun 6.

School of Biochemistry and Immunology & Trinity College Institute of Neuroscience, Dublin 2, Ireland.

Systemic inflammation can impair cognition with relevance to dementia, delirium and post-operative cognitive dysfunction. Episodes of delirium also contribute to rates of long-term cognitive decline, implying that these acute events induce injury. Whether systemic inflammation-induced acute dysfunction and acute brain injury occur by overlapping or discrete mechanisms remains unexplored. Read More

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October 2019

Dexamethasone as an Adjuvant to Femoral Nerve Block in Children and Adolescents Undergoing Knee Arthroscopy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

Reg Anesth Pain Med 2018 May;43(4):438-444

Background And Objectives: Perineural dexamethasone has been demonstrated to extend postsurgical analgesia after peripheral nerve blockade in adults. The mechanism of action of dexamethasone as a regional anesthetic adjuvant is unclear as intravenous dexamethasone has been shown to have similar analgesic efficacy as perineural dexamethasone. The efficacy of perineural dexamethasone has not been previously explored in the pediatric population. Read More

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Acute Changes in Mentation in a Patient with Hepatic Cirrhosis Treated with High Doses of Dexamethasone.

Cureus 2017 Sep 10;9(9):e1675. Epub 2017 Sep 10.

Division of Clinical & Translational Research, Larkin Community Hospital.

Despite the anti-inflammatory benefits of steroids in the management of multiple medical conditions, they are associated with undesired metabolic and psychiatric side effects. We present a case of a 57-year-old Hispanic man with hepatic cirrhosis due to hepatitis C and no past medical history of psychiatric illnesses who became delirious after treatment with high doses of intravenous Dexamethasone. The patient presented to Larkin Community Hospital, USA with complaints of lower back pain requiring treatment with steroids for severe lumbar central canal stenosis. Read More

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September 2017

Off-Label Medication Use in the Inpatient Palliative Care Unit.

J Pain Symptom Manage 2017 07 4;54(1):46-54. Epub 2017 May 4.

Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Context: Although off-label medications are frequently prescribed in palliative care, there are no published studies examining their use in the U.S.

Objectives: We examined the frequency of off-label medication use in cancer patients admitted to an acute palliative care unit (APCU). Read More

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Clinically Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion Accompanied by Epstein-Barr Virus Hemophagocytic Lymphohistiocytosis: A Case Report and Review of the Literature.

J Pediatr Hematol Oncol 2017 03;39(2):e92-e96

Departments of *Emergency and Critical Care Medicine †Hematology and Oncology ‡Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe §Division of Advanced Medicine for Virus Infections, National Research Institute for Child Health and Development, Tokyo, Japan.

Central nervous system involvement in hemophagocytic lymphohistiocytosis (HLH) is associated with a poor outcome. For such patients, it is unknown whether more aggressive therapies, such as intrathecal methotrexate or hydrocortisone, are inevitably required. We present a very rare case of 3-year-old Japanese girl who developed mild encephalitis/encephalopathy with a reversible splenial lesion, accompanied by Epstein-Barr virus-associated HLH, and review previous similar reports. Read More

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Prevention of Post-operative Delirium in the Elderly Using Pharmacological Agents.

Can Geriatr J 2016 Sep 30;19(3):113-126. Epub 2016 Sep 30.

Department of Geriatric Medicine, Jewish General Hospital, McGill University, Montreal, PQ.

Introduction: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Read More

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September 2016

Salmonella Typhi-Induced Septic Shock and Acute Respiratory Distress Syndrome in a Previously Healthy Teenage Patient Treated With High-Dose Dexamethasone.

J Investig Med High Impact Case Rep 2016 Apr-Jun;4(2):2324709616652642. Epub 2016 May 30.

University of Oklahoma Health Science Center, Oklahoma City, OK, USA.

Typhoid fever is commonly characterized by fever and abdominal pain. Rare complications include intestinal hemorrhage, bowel perforation, delirium, obtundation, and septic shock. Herein we describe the case of a previously healthy 16-year-old male without history of travel, diagnosed with typhoid fever complicated by septic shock and acute respiratory distress syndrome treated with high-dose dexamethasone. Read More

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The role of anesthesia in the prevention of postoperative delirium: a systematic review.

Minerva Anestesiol 2016 Jun 28;82(6):669-83. Epub 2016 Jan 28.

Neuroanesthesia and Intensive Care Unit, Carlo Besta Neurological Institute, Milan, Italy -

Introduction: Postoperative delirium (POD) is defined as an acute neurologic insult characterized by changes in consciousness and cognition, altered perception and a fluctuating course. It leads to poor outcome and increased health care system costs. Considering its high incidence, up to 60%, and the lack of a first-choice treatment, prevention has become a priority. Read More

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Cognitive Dysfunction After Cranial Radiation for a Brain Tumor.

J Pediatric Infect Dis Soc 2016 Mar 12;5(1):96-9. Epub 2016 Jan 12.

Department of Pediatrics.

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Intraoperative hypotension and delirium after on-pump cardiac surgery.

Br J Anaesth 2015 Sep 25;115(3):427-33. Epub 2015 Jul 25.

Department of Intensive Care Medicine, University Medical Center Utrecht, P.O. Box 85500, Utrecht 3508 GA, the Netherlands.

Background: Delirium is a common complication after cardiac surgery and may be as a result of inadequate cerebral perfusion. We studied delirium after cardiac surgery in relation to intraoperative hypotension (IOH).

Methods: This observational single-centre, cohort study was nested in a randomized trial, on a single intraoperative dose of dexamethasone vs placebo during cardiac surgery. Read More

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September 2015

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis.

BMC Med 2015 Jun 18;13:142. Epub 2015 Jun 18.

Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.

Background: Serotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients, but these agents may be harmful. We conducted a systematic review on the comparative safety of 5-HT3 receptor antagonists.

Methods: Searches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT3 receptor antagonists with each other, placebo, and/or other antiemetic agents for patients undergoing surgical procedures. Read More

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Delirium, steroids, and cardiac surgery.

Anesth Analg 2014 Nov;119(5):1011-3

From the *Division of Cardiac Anesthesia, Department of Anesthesiology and Critical Care Medicine, †Department of Psychiatry and Behavioral Sciences, ‡Division of Pulmonary and Critical Care Medicine, and §Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland.

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November 2014

Pharmacologic agents for the prevention and treatment of delirium in patients undergoing cardiac surgery: systematic review and metaanalysis.

Crit Care Med 2015 Jan;43(1):194-204

Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.

Objectives: Postcardiac surgery delirium is associated with increased risks of morbidity, cognitive decline, poor health-related quality of life and mortality, and higher healthcare costs. We performed a systematic review of randomized controlled trials to examine the effect of pharmacologic agents for the prevention and the treatment of delirium after cardiac surgery.

Data Sources: Electronic search on PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, ISI Web of Science, and CINAHL up to December 2013. Read More

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January 2015