Latest & greatest articles for delirium

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Top results for delirium

81. Effect of Dexmedetomidine Added to Standard Care on Ventilator-Free Time in Patients With Agitated Delirium: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Dexmedetomidine Added to Standard Care on Ventilator-Free Time in Patients With Agitated Delirium: A Randomized Clinical Trial. Effective therapy has not been established for patients with agitated delirium receiving mechanical ventilation.To determine the effectiveness of dexmedetomidine when added to standard care in patients with agitated delirium receiving mechanical ventilation.The Dexmedetomidine to Lessen ICU Agitation (DahLIA) study was a double-blind, placebo-controlled (...) , parallel-group randomized clinical trial involving 74 adult patients in whom extubation was considered inappropriate because of the severity of agitation and delirium. The study was conducted at 15 intensive care units in Australia and New Zealand from May 2011 until December 2013. Patients with advanced dementia or traumatic brain injury were excluded.Bedside nursing staff administered dexmedetomidine (or placebo) initially at a rate of 0.5 µg/kg/h and then titrated to rates between 0 and 1.5 µg/kg/h

2016 JAMA Controlled trial quality: predicted high

82. Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines

Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines (...) : Clinical Effectiveness and Guidelines Published on: January 14, 2016 Project Number: RC0744-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other sedative hypnotic agents? What are the evidence-based guidelines for the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

83. Systematic review and meta-analysis: Earplugs might reduce intensive care unit delirium but quality of evidence is low

Systematic review and meta-analysis: Earplugs might reduce intensive care unit delirium but quality of evidence is low Earplugs might reduce intensive care unit delirium but quality of evidence is low | BMJ Evidence-Based Medicine 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 Earplugs might reduce intensive care unit delirium but quality of evidence is low Article Text Therapeutics/Prevention Systematic review and meta-analysis Earplugs might reduce intensive

2016 Evidence-Based Medicine

84. Routine use of antipsychotics to prevent or treat delirium is not recommended

Routine use of antipsychotics to prevent or treat delirium is not recommended Routine use of antipsychotics to prevent or treat delirium is not recommended | Evidence-Based Mental Health 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 Routine use of antipsychotics to prevent or treat delirium is not recommended Article Text Commentaries Pharmacological interventions Routine use of antipsychotics to prevent or treat delirium is not recommended Taro Kishi Statistics

2016 Evidence-Based Mental Health

85. Delirium

Delirium Delirium - NICE CKS Share Delirium: Summary Delirium (sometimes called 'acute confusional state') is an acute, fluctuating syndrome of inattention, impaired level of consciousness, and disturbed cognition. Delirium can be classified into subtypes based on symptoms: Hyperactive delirium can present with inappropriate behaviour, hallucinations, or agitation. Hypoactive delirium can present with lethargy and reduced concentration and appetite. Mixed delirium presents with signs (...) and symptoms of both hyperactive and hypoactive subtypes. The prevalence of delirium in primary care is thought to be between 1–2%. Delirium typically occurs in people with a predisposing factor (such as advanced age or multiple co-morbidities) when new precipitating factors (such as some medications or infection) are added. A diagnosis of delirium can be made if criteria from an assessment tool such as the short Confusion Assessment Method (short-CAM) or the Diagnostic and Statistical Manual of Mental

2016 NICE Clinical Knowledge Summaries

86. Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition

Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition Clinical Best Practice Guidelines JULY 2016 Delirium, Dementia, and Depression in Older Adults: Assessment and Care Second EditionDisclaimer These guidelines are not binding for nurses or the organizations that employ them. The use of these guidelines should be flexible based on individual needs and local circumstances. They neither constitute a liability nor discharge from liability. While every effort has (...) appears, the balance of this document may be produced, reproduced, and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, written permission must be obtained from RNAO. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses’ Association of Ontario. (2016). Delirium, Dementia, and Depression in Older Adults

2016 Registered Nurses' Association of Ontario

87. Pediatric delirium and associated risk factors: a single-center prospective observational study

Pediatric delirium and associated risk factors: a single-center prospective observational study PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2015 PedsCCM Evidence-Based Journal Club

88. Constant Observation Monitors for Geriatric Patients with Dementia or Delirium: Clinical and Cost-Effectiveness

Constant Observation Monitors for Geriatric Patients with Dementia or Delirium: Clinical and Cost-Effectiveness Constant Observation Monitors for Geriatric Patients with Dementia or Delirium: Clinical and Cost-Effectiveness | CADTH.ca Find the information you need Constant Observation Monitors for Geriatric Patients with Dementia or Delirium: Clinical and Cost-Effectiveness Constant Observation Monitors for Geriatric Patients with Dementia or Delirium: Clinical and Cost-Effectiveness Published (...) on: September 10, 2015 Project Number: RA0806-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical effectiveness of using constant observation monitors for geriatric patients with dementia or delirium? What is the cost-effectiveness of using constant observation monitors for geriatric patients with dementia or delirium? Key Message No relevant literature was identified regarding the clinical or cost-effectiveness of using constant

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

89. Delirium and cognitive decline after surgery: a randomised controlled trial of anaesthetic management to improve postoperative mental health outcome. (Abstract)

Delirium and cognitive decline after surgery: a randomised controlled trial of anaesthetic management to improve postoperative mental health outcome. 25647822 2015 09 28 2016 10 20 1024-2708 20 Suppl 7 2014 Dec Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Med J Delirium and cognitive decline after surgery: a randomised controlled trial of anaesthetic management to improve postoperative mental health outcome. 28-9 Chan M T V MT Department of Anaesthesia and Intensive Care (...) , The Chinese University of Hong Kong. Gin T T Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong. eng Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't China Hong Kong Med J 9512509 1024-2708 0 Anesthetics IM Aged Anesthetics administration & dosage Cognition Disorders epidemiology etiology prevention & control Colon surgery Consciousness Monitors Delirium epidemiology etiology prevention & control Humans Postoperative

2015 Hong Kong medical journal = Xianggang yi xue za zhi Controlled trial quality: uncertain

90. The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients Full Text available with Trip Pro

The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients Delirium is frequently missed in older emergency department (ED) patients. Brief (<2 minutes) delirium assessments have been validated for the ED, but some ED health care providers may consider them to be cumbersome. The Richmond Agitation Sedation Scale (RASS) is an observational scale that quantifies level of consciousness and takes less than 10 seconds to perform (...) . The authors sought to explore the diagnostic accuracy of the RASS for delirium in older ED patients.This was a preplanned analysis of a prospective observational study designed to validate brief delirium assessments for the ED. The study was conducted at an academic ED and enrolled patients who were 65 years or older. Patients who were non-English-speaking, deaf, blind, comatose or had end-stage dementia were excluded. A research assistant (RA) and a physician performed the RASS at the time of enrollment

2015 EvidenceUpdates

91. Intraoperative tight glucose control using hyperinsulinemic normoglycemia increases delirium after cardiac surgery Full Text available with Trip Pro

Intraoperative tight glucose control using hyperinsulinemic normoglycemia increases delirium after cardiac surgery Postoperative delirium is common in patients recovering from cardiac surgery. Tight glucose control has been shown to reduce mortality and morbidity. Therefore, the authors sought to determine the effect of tight intraoperative glucose control using a hyperinsulinemic-normoglycemic clamp approach on postoperative delirium in patients undergoing cardiac surgery.The authors enrolled (...) 198 adult patients having cardiac surgery in this randomized, double-blind, single-center trial. Patients were randomly assigned to either tight intraoperative glucose control with a hyperinsulinemic-normoglycemic clamp (target blood glucose, 80 to 110 mg/dl) or standard therapy (conventional insulin administration with blood glucose target, <150 mg/dl). Delirium was assessed using a comprehensive delirium battery. The authors considered patients to have experienced postoperative delirium when

2015 EvidenceUpdates Controlled trial quality: predicted high

92. Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines

Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses (...) with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines DATE: 17 April 2015 RESEARCH QUESTIONS 1. What is the clinical effectiveness of the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other sedative hypnotic agents? 2. What are the evidence-based guidelines for the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other sedative hypnotic agents? KEY FINDINGS Three systematic reviews

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

93. Delirium risk stratification in consecutive unselected admissions to acute medicine: validation of externally derived risk scores Full Text available with Trip Pro

Delirium risk stratification in consecutive unselected admissions to acute medicine: validation of externally derived risk scores reliable delirium risk stratification will aid recognition, anticipation and prevention and will facilitate targeting of resources in clinical practice as well as identification of at-risk patients for research. Delirium risk scores have been derived for acute medicine, but none has been prospectively validated in external cohorts. We therefore aimed to determine (...) the reliability of externally derived risk scores in a consecutive cohort of older acute medicine patients.consecutive patients aged ≥65 over two 8-week periods (2010, 2012) were screened prospectively for delirium using the Confusion Assessment Method (CAM), and delirium was diagnosed using the DSM IV criteria. The reliability of existing delirium risk scores derived in acute medicine cohorts and simplified for use in routine clinical practice (USA, n = 2; Spain, n = 1; Indonesia, n = 1) was determined

2015 EvidenceUpdates

94. Delirium

Delirium Scottish Palliative Care Guidelines - Delirium Scottish Palliative Care Guidelines search / / / Delirium Delirium Introduction In this guideline, delirium is defined as disturbed consciousness and inattention with cognitive impairment; acute onset and fluctuating course as a physiological consequence of disease or treatment. Delirium is often reversible. Other terms used to describe delirium include acute confusional state, agitation, and terminal restlessness, but the terms (...) and deafness are risk factors. Differential diagnosis: , dementia (increased risk of developing delirium). Investigations Check full blood count and biochemistry, including calcium Check for infection (urine infection in the elderly) Review all medication and stop any non-essential drugs Assess for sensory impairment Check for opioid toxicity (drowsiness, agitation, myoclonus, hypersensitivity to touch) reduce opioid dose by 1/3rd. Consider switching to another opioid if delirium persists Check

2015 Scottish Palliative Care Guidelines

95. The 3D-CAM provides a brief, easy to use, sensitive and specific delirium assessment tool for older hospitalised patients, both with and without dementia

The 3D-CAM provides a brief, easy to use, sensitive and specific delirium assessment tool for older hospitalised patients, both with and without dementia The 3D-CAM provides a brief, easy to use, sensitive and specific delirium assessment tool for older hospitalised patients, both with and without dementia | Evidence-Based Mental Health 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 The 3D-CAM provides a brief, easy to use, sensitive and specific delirium

2015 Evidence-Based Mental Health

96. 3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium: A Cross-sectional Diagnostic Test Study. Full Text available with Trip Pro

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium: A Cross-sectional Diagnostic Test Study. Delirium is common, leads to other adverse outcomes, and is costly. However, it often remains unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would be a substantial advance for clinical care.To derive the 3D-CAM, a new 3-minute diagnostic assessment (...) for CAM-defined delirium, and validate it against a clinical reference standard.Derivation and validation study.4 general medicine units in an academic medical center.201 inpatients aged 75 years or older.20 items that best operationalized the 4 CAM diagnostic features were identified to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Clinicians independently did an extensive assessment, including patient and family interviews

2014 Annals of Internal Medicine

97. Cornell Assessment of Pediatric Delirium: A Valid, Rapid, Observational Tool for Screening Delirium in the PICU

Cornell Assessment of Pediatric Delirium: A Valid, Rapid, Observational Tool for Screening Delirium in the PICU PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2014 PedsCCM Evidence-Based Journal Club

98. Tryptophan Supplementation and Postoperative Delirium-A Randomized Controlled Trial Full Text available with Trip Pro

Tryptophan Supplementation and Postoperative Delirium-A Randomized Controlled Trial To determine whether the postoperative administration of tryptophan would be beneficial for elderly adults undergoing surgery who are at risk of developing postoperative delirium.Randomized, double-blind, placebo-controlled trial.Denver Veterans Affairs Medical Center.Individuals aged 60 and older undergoing major elective operations requiring a postoperative intensive care unit (ICU) admission (n = 325).L (...) -tryptophan, 1 g orally three times a day or placebo was started after surgery and continued for up to 3 days postoperatively.Delirium and its motor subtypes were measured using the Confusion Assessment Method-Intensive Care Unit (CAM-ICU) and the Richmond Agitation and Sedation Scale. The primary outcome for between-group comparison was the incidence of excitatory (mixed and hyperactive) postoperative delirium. The secondary outcomes for comparison were the incidence and duration of overall postoperative

2014 EvidenceUpdates Controlled trial quality: predicted high

99. Excited Delirium Syndrome and Sudden Death

Excited Delirium Syndrome and Sudden Death BestBets: Excited Delirium Syndrome and Sudden Death Excited Delirium Syndrome and Sudden Death Report By: Karl Huesgen, MD - Resident Physician Search checked by Bryan Judge MD - Faculty Physician Institution: Grand Rapids Medical Education Partners/Michigan State University, USA Date Submitted: 7th September 2012 Date Completed: 24th February 2014 Last Modified: 24th February 2014 Status: Green (complete) Three Part Question In [adult patients (...) ] presenting to the Emergency Department with suspected [excited delirium syndrome], what are the [clinical features associated with significant morbidity and mortality]? Clinical Scenario You are working a shift in an Emergency Department (ED), and you receive a call from prehospital providers requesting advice in management of a violent and incoherent patient with strength far in excess of expected for his size. This seems consistent with reports you have read of Excited Delirium Syndrome (EXDS). You

2014 BestBETS

100. Delirium Severity in the Hospitalized Patient: Time to Pay Attention Full Text available with Trip Pro

Delirium Severity in the Hospitalized Patient: Time to Pay Attention 24733202 2014 06 09 2018 12 02 1539-3704 160 8 2014 Apr 15 Annals of internal medicine Ann. Intern. Med. Delirium severity in the hospitalized patient: time to pay attention. 574-5 10.7326/M14-0553 Eubank Kathryn J KJ Covinsky Kenneth E KE eng K24 AG029812 AG NIA NIH HHS United States P30 AG044281 AG NIA NIH HHS United States K24AG029812 AG NIA NIH HHS United States P30AG044281 AG NIA NIH HHS United States Editorial Research (...) Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Comment United States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2014 Apr 15;160(8):526-33 24733193 Delirium diagnosis Female Humans Male Psychological Tests 2014 4 16 6 0 2014 4 16 6 0 2014 6 10 6 0 ppublish 24733202 1860540 10.7326/M14-0553 PMC4112185 NIHMS602295 Ann Intern Med. 2014 Apr 15;160(8):526-33 24733193 Ann Intern Med. 1990 Dec 15;113(12):941-8 2240918 N Engl J Med. 2006 Mar 16;354(11):1157-65 16540616 Age Ageing

2014 Annals of Internal Medicine