Latest & greatest articles for delirium

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Top results for delirium

41. Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial. Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium.To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days.Randomized (...) , double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands. Patients without delirium whose expected ICU stay was at least a day were included. Recruitment was from July 2013 to December 2016 and follow-up was conducted at 90 days with the final follow-up on March 1, 2017.Patients received prophylactic treatment 3 times daily intravenously

2018 JAMA Controlled trial quality: predicted high

42. Best practices for managing sleep in intensive care patients to reduce the risk of delirium

Best practices for managing sleep in intensive care patients to reduce the risk of delirium Best practices for managing sleep in intensive care patients to reduce the risk of delirium We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Best practices for managing sleep in intensive care patients to reduce the risk of delirium Share: Reading time approx (...) . 1 minute Delirium is a disturbance of consciousness with reduced ability to focus, sustain or shift attention, which develops over a short period of time and involves a change in cognition. It may lead to higher morbidity, long term deterioration of cognitive and functional processes and mortality. Seriously ill intensive care patients may experience their care as extremely strenuous due to pain, anxiety, foreign environment and side effects of various potent drugs. Many factors may thus

2018 Swedish Council on Technology Assessement

43. Extended visitation policy may lower risk for delirium in the intensive care unit Full Text available with Trip Pro

Extended visitation policy may lower risk for delirium in the intensive care unit Extended visitation policy may lower risk for delirium in the intensive care unit | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts (...) Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Extended visitation policy may lower risk for delirium in the intensive care unit Article Text Commentary Adult nursing Extended visitation policy may lower risk for delirium in the intensive care unit Manuel Schwanda , Rita Gruber

2018 Evidence-Based Nursing

44. Single-Blinded Randomized Controlled Study on Use of Interactive Distraction Versus Oral Midazolam to Reduce Pediatric Preoperative Anxiety, Emergence Delirium, and Postanesthesia Length of Stay. (Abstract)

Single-Blinded Randomized Controlled Study on Use of Interactive Distraction Versus Oral Midazolam to Reduce Pediatric Preoperative Anxiety, Emergence Delirium, and Postanesthesia Length of Stay. The purpose of this study was to compare effects of tablet-based interactive distraction (TBID; 1 minute preseparation) with oral midazolam (15 to 45 minutes of preseparation) on preoperative anxiety, emergence delirium, and postanesthesia length of stay in children, 4 to 12 years undergoing outpatient (...) surgery.Single-blinded prospective design with randomized assignment to TBID or oral midazolam group was conducted at a large pediatric hospital in southwestern United States.A total of 102 children and caregivers were enrolled. Outcome measures included anxiety scores at baseline, separation, and mask induction; postemergence delirium scores; caregiver ratings of child anxiety and satisfaction; and time from postanesthesia care unit arrival to discharge and posthospital behaviors.The TBID group demonstrated

2018 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses Controlled trial quality: uncertain

45. Assessment of delirium

Assessment of delirium Assessment of delirium - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of delirium Last reviewed: February 2019 Last updated: June 2018 Summary Introduction Delirium is an acute, fluctuating change in mental status, with inattention, disorganised thinking, and altered levels of consciousness. Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing (...) older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73. http://www.ncbi.nlm.nih.gov/pubmed/10335730?tool=bestpractice.com It is a potentially life-threatening disorder characterised by high morbidity and mortality. Guidelines address recognition, risk factors, and treatment for delirium. Barr J, Fraser GL, Puntillo K, et al; American College of Critical Care Medicine. Clinical practice guidelines for the management of pain, agitation, and delirium in adult

2018 BMJ Best Practice

46. A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty (Abstract)

A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA.Our group (...) developed a protocol to identify and prevent delirium in patients undergoing TJA. All patients were screened and scored in the preoperative assessment, on criteria such as age, history of forgetfulness, history of agitation or visual hallucinations, history of falls, history of postoperative confusion, and inability to perform higher brain functions. Patients were scored on performance in a simple mental examination. The patients were classified as low, medium, or high risk. Patients who were identified

2018 EvidenceUpdates

47. In patients receiving palliative care, risperidone or haloperidol increased delirium symptoms vs placebo. (Abstract)

In patients receiving palliative care, risperidone or haloperidol increased delirium symptoms vs placebo. 28320006 2017 12 08 2018 12 02 1539-3704 166 6 2017 03 21 Annals of internal medicine Ann. Intern. Med. In patients receiving palliative care, risperidone or haloperidol increased delirium symptoms vs placebo. JC32 10.7326/ACPJC-2017-166-6-032 Lee Justin J Holbrook Anne A McMaster UniversityHamilton, Ontario, Canada. eng Journal Article Comment United States Ann Intern Med 0372351 0003-4819 (...) 0 Antipsychotic Agents J6292F8L3D Haloperidol L6UH7ZF8HC Risperidone AIM IM JAMA Intern Med. 2017 Jan 1;177(1):34-42 27918778 Antipsychotic Agents Delirium Double-Blind Method Haloperidol Humans Palliative Care Risperidone 2017 3 21 6 0 2017 3 21 6 0 2017 12 9 6 0 ppublish 28320006 2612421 10.7326/ACPJC-2017-166-6-032

2017 Annals of Internal Medicine Controlled trial quality: uncertain

48. Delirium and Benzodiazepines Associated With Prolonged ICU Stay in Critically Ill Infants and Young Children

Delirium and Benzodiazepines Associated With Prolonged ICU Stay in Critically Ill Infants and Young Children PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

49. A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents Full Text available with Trip Pro

A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents care home residents are particularly at risk of delirium due to high prevalence of dementia. The Delirium Observation Screening Scale (DOSS) identifies behavioural changes associated delirium onset that nursing staff are uniquely placed to recognise. We tested the psychometric properties of the DOSS in UK care homes compared with the Confusion (...) Assessment Method (CAM).prospective observational cohort study performed between 1 March 2015 and 30 June 2016.nine UK residential and nursing care homes.residents over 65 years except those approaching end of life or unable to complete delirium assessments.the 25-item DOSS was completed daily by care home staff and compared with the temporally closest CAM performed twice per week by trained researchers. Sensitivity, specificity, positive and negative predictive values, diagnostic odds and likelihood

2017 EvidenceUpdates

50. Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees Full Text available with Trip Pro

Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees screening for cognitive impairment in Emergency Department (ED) requires short, reliable tools.to validate the 4AT and 6-Item Cognitive Impairment Test (6-CIT) for ED dementia and delirium screening.diagnostic accuracy study.attendees aged ≥70 years in a tertiary care hospital's ED.trained researchers assessed participants using (...) the Standardised Mini Mental State Examination, Delirium Rating Scale-Revised 98 and Informant Questionnaire on Cognitive Decline in the Elderly, informing ultimate expert diagnosis using Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for dementia and delirium (reference standards). Another researcher blindly screened each participant, within 3 h, using index tests 4AT and 6-CIT.of 419 participants (median age 77 years), 15.2% had delirium and 21.5% had dementia. For delirium detection

2017 EvidenceUpdates

51. Haloperidol versus placebo for delirium prevention in acutely hospitalised older at risk patients: a multi-centre double-blind randomised controlled clinical trial Full Text available with Trip Pro

Haloperidol versus placebo for delirium prevention in acutely hospitalised older at risk patients: a multi-centre double-blind randomised controlled clinical trial because the few randomised placebo-controlled trials investigating the potential role for prophylactic haloperidol in delirium prevention have focused on specific surgical populations, we investigated its efficacy and safety in acutely hospitalised older patients.this multi-centre, double-blind, stratified, block randomised, placebo (...) -controlled trial was conducted at six Dutch hospitals. Patients age ≥70 years, acutely admitted through the emergency department for general medicine or surgical specialties and at risk for delirium were randomised (n = 245) to haloperidol or placebo 1 mg orally twice-daily (maximum of 14 doses) on top of standard nonpharmacological prevention strategies. The primary outcome was delirium incidence. Other endpoints included delirium severity and duration, drug safety and clinical outcomes.intention

2017 EvidenceUpdates

52. Development of the Japanese version of the Cornell Assessment of Pediatric Delirium Full Text available with Trip Pro

Development of the Japanese version of the Cornell Assessment of Pediatric Delirium Delirium is a form of acute cerebral dysfunction and is associated with increased length of hospital stay, mortality, and health-care costs for adult patients in intensive care. However, in Japan, there are currently no reliable criteria or tools for diagnosing delirium in critically ill pediatric patients. The purpose of this study was to translate the Cornell Assessment of Pediatric Delirium (CAPD)-a screening (...) tool for pediatric delirium-from English to Japanese for use in the diagnosis of delirium for pediatric patients in pediatric intensive care units.The back-translation method was used to ensure equivalence in the Japanese version of the CAPD and its accompanying developmental anchor points. The translation process was repeated by a multidisciplinary committee of medical researchers and clinicians.The final back-translated version of the CAPD was submitted to the original author, who gave her

2017 Acute medicine & surgery

53. Delirium in Older Persons: Advances in Diagnosis and Treatment. Full Text available with Trip Pro

Delirium in Older Persons: Advances in Diagnosis and Treatment. Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effects with substantial health care costs.To summarize the current state of the art in diagnosis and treatment of delirium and to highlight (...) critical areas for future research to advance the field.Search of Ovid MEDLINE, Embase, and the Cochrane Library for the past 6 years, from January 1, 2011, until March 16, 2017, using a combination of controlled vocabulary and keyword terms. Since delirium is more prevalent in older adults, the focus was on studies in elderly populations; studies based solely in the intensive care unit (ICU) and non-English-language articles were excluded.Of 127 articles included, 25 were clinical trials, 42 cohort

2017 JAMA

54. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. The use of benzodiazepines to control agitation in delirium in the last days of life is controversial.To compare the effect of lorazepam vs placebo as an adjuvant to haloperidol for persistent agitation in patients with delirium in the setting of advanced cancer.Single-center, double-blind, parallel-group, randomized clinical (...) trial conducted at an acute palliative care unit at MD Anderson Cancer Center, Texas, enrolling 93 patients with advanced cancer and agitated delirium despite scheduled haloperidol from February 11, 2014, to June 30, 2016, with data collection completed in October 2016.Lorazepam (3 mg) intravenously (n = 47) or placebo (n = 43) in addition to haloperidol (2 mg) intravenously upon the onset of an agitation episode.The primary outcome was change in Richmond Agitation-Sedation Scale (RASS) score (range

2017 JAMA Controlled trial quality: predicted high

55. Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial Full Text available with Trip Pro

Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery.Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N (...) = 350) administered preoperatively and for the first 3 postoperative days. The primary outcome was postoperative delirium as measured by the Confusion Assessment Method. Secondary outcomes were postoperative pain, opioid use, and length of hospital stay.Data for 697 patients were included, with a mean ± SD age of 72 ± 6 yr. The overall incidence of postoperative delirium in any of the first 3 days was 22.4% (24.0% in the gabapentin and 20.8% in the placebo groups; the difference was 3.20%; 95% CI

2017 EvidenceUpdates

56. CRACKCast E104 – Delirium and Dementia

CRACKCast E104 – Delirium and Dementia CRACKCast E104 – Delirium and Dementia - CanadiEM CRACKCast E104 – Delirium and Dementia In , by Adam Thomas August 28, 2017 This episode of CRACKCast covers Rosen’s Chapter 94, Delirium and Dementia. These are common presentations in the emergency department, and this episode will focus on screening, diagnosis, and management. Shownotes – Rosens in Perspective: “Delirium is characterized by a fluctuating neurobehavioral disturbance typically progressing (...) over a short period. It is a direct consequence of an acute systemic or central nervous system (CNS) stressor. Dementia, on the other hand, tends to follow a more gradual course, with evolution occurring over months to years. Although patients with dementia exhibit confusion, unlike delirium, manifestations of autonomic nervous system abnormalities are minimal or absent and a disturbance in level of consciousness usually is not a feature.” These big topics fall under the term neurobehavioural

2017 CandiEM

57. Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: results from a large observational study Full Text available with Trip Pro

Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: results from a large observational study Postinjection delirium/sedation syndrome (PDSS) has been reported uncommonly during treatment with olanzapine long-acting injection (LAI), a sustained-release formulation of olanzapine.The primary aim of the study was to estimate the incidence per injection and per patient of PDSS events in adult patients with schizophrenia who were

2017 BJPsych open

58. Patterns of Postoperative Delirium in Children

Patterns of Postoperative Delirium in Children PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

59. The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care Full Text available with Trip Pro

The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a 'bundle' of principles to reduce (...) delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium. The purpose of this analysis is to review the current literature and develop a mnemonic, which may help facilitate collaborative working for patients with delirium. Electronic databases were searched for non-pharmacological managements of delirium within intensive care settings, after 2006. Critical appraisal

2017 Journal of the Intensive Care Society

60. Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery: A Randomized Clinical Trial Full Text available with Trip Pro

Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery: A Randomized Clinical Trial Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased hospital costs, and 1-year mortality. Emerging literature suggests that dexmedetomidine sedation in critical care units is associated with reduced (...) incidence of delirium. However, intraoperative use of dexmedetomidine for prevention of delirium has not been well studied.To evaluate whether an intraoperative infusion of dexmedetomidine reduces postoperative delirium.This study was a multicenter, double-blind, randomized, placebo-controlled trial that randomly assigned patients to dexmedetomidine or saline placebo infused during surgery and for 2 hours in the recovery room. Patients were assessed daily for postoperative delirium (primary outcome

2017 EvidenceUpdates