Latest & greatest articles for delirium

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This page lists the very latest high quality evidence on delirium and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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Top results for delirium

1. Interventions for preventing intensive care unit delirium in adults.

Interventions for preventing intensive care unit delirium in adults. BACKGROUND: Delirium is defined as a disturbance in attention, awareness and cognition with reduced ability to direct, focus, sustain and shift attention, and reduced orientation to the environment. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium. It can profoundly affect both them and their families because it is associated with increased mortality, longer duration of mechanical (...) ventilation, longer hospital and ICU stay and long-term cognitive impairment. It also results in increased costs for society. OBJECTIVES: To assess existing evidence for the effect of preventive interventions on ICU delirium, in-hospital mortality, the number of delirium- and coma-free days, ventilator-free days, length of stay in the ICU and cognitive impairment. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, BIOSIS, International Web of Science, Latin American Caribbean Health Sciences Literature, CINAHL

Cochrane2018

2. Delirium is common among adults receiving palliative care and could be better recognised

Delirium is common among adults receiving palliative care and could be better recognised Delirium recognition in palliative care Dissemination Centre Discover Portal NIHR DC Discover Delirium is common among adults receiving palliative care and could be better recognised Published on 20 November 2018 doi: Between a quarter and two-thirds of adults admitted to specialist palliative care units experience delirium, or acute confusion. The findings come from a mixed methods project which included (...) a systematic review of the number of people living with delirium. Estimates are mostly applicable to older adults with advanced cancer. The project also included interviews with nurses in Australian palliative care units to look at delirium assessment and use of screening tools. The findings highlighted that systems which formally diagnose delirium were not commonly used. Delirium guidelines made little reference to palliative care. The qualitative findings may also have relevance to the UK, though systems

NIHR Dissemination Centre2018

3. Comprehensive assessment may reduce risk of delirium after hip fracture

Comprehensive assessment may reduce risk of delirium after hip fracture Signal - Comprehensive assessment may reduce risk of delirium after hip fracture Dissemination Centre Discover Portal NIHR DC Discover Comprehensive assessment may reduce risk of delirium after hip fracture Published on 29 August 2017 Comprehensive geriatric assessment reduced the risk of delirium by 20% in patients having hip fracture surgery. Forty-three percent developed delirium on average compared with 53% who didn’t (...) receive these assessments. The assessment of the older persons’ medical condition was typically undertaken by a team of healthcare professionals who assessed functional ability, living circumstances and risk factors in order to develop a tailored plan for prevention and treatment of delirium after surgery. This review identified four trials in people having surgery for hip fracture. Two assessed teams where geriatricians visited patients on orthopaedic wards. The other trials reported ward assessments

NIHR Dissemination Centre2018

4. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness.

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. BACKGROUND: There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU). METHODS: In a randomized, double-blind, placebo-controlled trial, we assigned patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to receive intravenous boluses of haloperidol (maximum dose, 20 mg daily), ziprasidone (maximum dose, 40 mg daily (...) ), or placebo. The volume and dose of a trial drug or placebo was halved or doubled at 12-hour intervals on the basis of the presence or absence of delirium, as detected with the use of the Confusion Assessment Method for the ICU, and of side effects of the intervention. The primary end point was the number of days alive without delirium or coma during the 14-day intervention period. Secondary end points included 30-day and 90-day survival, time to freedom from mechanical ventilation, and time to ICU and

NEJM2018

5. Mind the gap on UTI?s and delirium

Mind the gap on UTI?s and delirium Core IM: Mind the Gap on UTI’s and Delirium – Clinical Correlations Search Core IM: Mind the Gap on UTI’s and Delirium September 12, 2018 Podcast: | Subscribe: | Join us in this episode as we question everything you ever thought you knew about… urinary tract infections (UTI) and delirium. || By Steven R. Liu MD, Charlie Madeira MD and Dr. Janine Knudsen MD || Graphic Design by Ramon Thompson Time Stamps: The basics – what are the official (IDSA) definitions (...) for bacteriuria, pyuria, and UTI? (02:07) The lay of the land – how common are bacteriuria and delirium? (07:09) The big money question – do UTIs really cause delirium and what does the evidence tell us? (10:50) Review of teaching points (15:59) Thank you to infectious disease attendings from NYU and Bellevue Hospitals, Dr. Ellie Carmody and Dr. Tania Kupferman, for peer reviewing this podcast! Subscribe to CORE IM on any podcast app! Follow us on Facebook || Twitter || Instagram . Please give any feedback

Clinical Correlations2018

6. Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium: The STRIDE Randomized Clinical Trial

Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium: The STRIDE Randomized Clinical Trial 30090923 2018 08 09 2168-6262 2018 Aug 08 JAMA surgery JAMA Surg Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium: The STRIDE Randomized Clinical Trial. 10.1001/jamasurg.2018.2602 Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation (...) levels are a possible modifiable risk factor for postoperative delirium. To determine whether limiting sedation levels during spinal anesthesia reduces incident delirium overall. This double-blind randomized clinical trial (A Strategy to Reduce the Incidence of Postoperative Delirum in Elderly Patients [STRIDE]) was conducted from November 18, 2011, to May 19, 2016, at a single academic medical center and included a consecutive sample of older patients (≥65 years) who were undergoing nonelective hip

EvidenceUpdates2018

8. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial

Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial 29498534 2018 05 01 1535-4970 197 9 2018 May 01 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial. 1147-1156 10.1164/rccm.201710-1995OC Dexmedetomidine is associated with less delirium than benzodiazepines and better sleep architecture than either benzodiazepines (...) or propofol; its effect on delirium and sleep when administered at night to patients requiring sedation remains unclear. To determine if nocturnal dexmedetomidine prevents delirium and improves sleep in critically ill adults. This two-center, double-blind, placebo-controlled trial randomized 100 delirium-free critically ill adults receiving sedatives to receive nocturnal (9:30 p.m. to 6:15 a.m.) intravenous dexmedetomidine (0.2 μg/kg/h, titrated by 0.1 μg /kg/h every 15 min until a goal Richmond Agitation

EvidenceUpdates2018

9. Delirium

Delirium Top results for delirium - Trip Database or use your Google+ account Find evidence fast My query is: English Français Deutsch Čeština Español Magyar Svenska ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search (...) button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for delirium The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory

Trip Latest and Greatest2018

11. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis

Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis 29912008 2018 06 22 1528-1175 2018 Jun 15 Anesthesiology Anesthesiology Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. 10.1097/ALN.0000000000002323 Postoperative delirium complicates approximately 15 to 20% of major operations in patients at least 65 yr old and is associated with adverse outcomes and increased resource (...) utilization. Furthermore, patients with postoperative delirium might also be at risk of developing long-term postoperative cognitive dysfunction. One potentially modifiable variable is use of intraoperative processed electroencephalogram to guide anesthesia. This systematic review and meta-analysis examines the relationship between processed electroencephalogram monitoring and postoperative delirium and cognitive dysfunction. A systematic search for randomized controlled trials was conducted using Ovid

EvidenceUpdates2018

12. Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial

Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial 29729237 2018 06 23 1555-7162 2018 May 03 The American journal of medicine Am. J. Med. Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial. S0002-9343(18)30386-3 10.1016/j.amjmed.2018.04.009 Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20%-30% of hospitalized older adults that is associated with increased morbidity (...) and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. This was a randomized clinical trial measuring the impact of 3mg of melatonin nightly on incident delirium and both objective and subjective sleep in inpatients age ≥65years, admitted to internal medicine wards (non-intensive care units). Delirium incidence was measured by bedside nurses using the confusion assessment method. Objective

EvidenceUpdates2018

13. Cholinesterase inhibitors for the treatment of delirium in non-ICU settings.

Cholinesterase inhibitors for the treatment of delirium in non-ICU settings. BACKGROUND: Delirium is a common clinical syndrome defined as alterations in attention with an additional disturbance in cognition or perception, which develop over a short period of time and tend to fluctuate during the course of the episode. Delirium is commonly treated in hospitals or community settings and is often associated with multiple adverse outcomes such as increased cost, morbidity, and even mortality (...) . The first-line intervention involves a multicomponent non-pharmacological approach that includes ensuring effective communication and reorientation in addition to providing reassurance or a suitable care environment. There are currently no drugs approved specifically for the treatment of delirium. Clinically, however, various medications are employed to provide symptomatic relief, such as antipsychotic medications and cholinesterase inhibitors, among others. OBJECTIVES: To evaluate the effectiveness

Cochrane2018

14. Antipsychotics for treatment of delirium in hospitalised non-ICU patients.

Antipsychotics for treatment of delirium in hospitalised non-ICU patients. BACKGROUND: Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence. OBJECTIVES: Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration (...) of delirium in hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse effects; and 2) atypical vs. typical antipsychotics for reducing delirium duration, severity, and resolution, hospital mortality and length of stay, discharge disposition, health-related quality of life, and adverse

Cochrane2018

15. Attention, arousal and other rapid bedside screening instruments for delirium in older patients: a systematic review of test accuracy studies

Attention, arousal and other rapid bedside screening instruments for delirium in older patients: a systematic review of test accuracy studies 29697753 2018 04 26 1468-2834 2018 Apr 25 Age and ageing Age Ageing Attention, arousal and other rapid bedside screening instruments for delirium in older patients: a systematic review of test accuracy studies. 10.1093/ageing/afy058 delirium occurs frequently in frail patients but is easily missed. Screening with a rapid, easy-to-use and highly sensitive (...) instrument might help improve recognition. The aim of this study was to review attention, arousal and other rapid bedside screening instruments for delirium in older patients. a literature search was performed in PubMed, PsycINFO and Embase. We scrutinized forward citations in Google Scholar, and references of included articles and prior reviews. We included studies among older patients that investigated the sensitivity and specificity of delirium screening instruments that could be administered in 3 min

EvidenceUpdates2018

16. Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non-neurosurgical procedures in adults.

Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non-neurosurgical procedures in adults. BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through (...) -quality evidence). AUTHORS' CONCLUSIONS: There is moderate-quality evidence that optimized anaesthesia guided by processed EEG indices could reduce the risk of postoperative delirium in patients aged 60 years or over undergoing non-cardiac surgical and non-neurosurgical procedures. We found moderate-quality evidence that postoperative cognitive dysfunction at three months could be reduced in these patients. The effect on POCD at one week and over one year after surgery is uncertain. There are no data

Cochrane2018

17. Prognosis of delirium

Prognosis of delirium Prognosis of delirium | Evidence-Based Mental Health This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. 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 Prognosis of delirium Article Text Evidence-based case conference Prognosis of delirium Toshi A Furukawa Statistics from Altmetric.com Clinical case Patient: a woman aged 77 years Present illness The patient had type II diabetes since her 50s which had been fairly well controlled and also suffered from an old myocardial infarction, but had been able to live alone in her apartment, managing the household on her own. She caught a common cold several days ago

Evidence-Based Mental Health2018

18. Validation of Caregiver-Centered Delirium Detection Tools: A Systematic Review

Validation of Caregiver-Centered Delirium Detection Tools: A Systematic Review 29671281 2018 04 19 1532-5415 2018 Apr 18 Journal of the American Geriatrics Society J Am Geriatr Soc Validation of Caregiver-Centered Delirium Detection Tools: A Systematic Review. 10.1111/jgs.15362 To summarize the validity of caregiver-centered delirium detection tools in hospitalized adults and assess associated patient and caregiver outcomes. Systematic review. We searched MEDLINE, EMBASE, PsycINFO, CINAHL (...) , and Scopus from inception to May 15, 2017. Hospitalized adults. Caregiver-centered delirium detection tools. We drafted a protocol from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently completed abstract and full-text review, data extraction, and quality assessment. We summarized findings using descriptive statistics including mean, median, standard deviation, range, frequencies (percentages), and Cohen's kappa. Studies that reported

EvidenceUpdates2018

19. Comprehensive assessment may reduce risk of delirium after hip fracture

Comprehensive assessment may reduce risk of delirium after hip fracture NIHR DC | Signal - Comprehensive assessment may reduce risk of delirium after hip fracture Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Comprehensive assessment may reduce risk of delirium after hip fracture Published on 29 August 2017 Comprehensive geriatric assessment reduced the risk of delirium by 20% in patients having hip fracture surgery. Forty-three percent developed delirium on average compared (...) with 53% who didn’t receive these assessments. The assessment of the older persons’ medical condition was typically undertaken by a team of healthcare professionals who assessed functional ability, living circumstances and risk factors in order to develop a tailored plan for prevention and treatment of delirium after surgery. This review identified four trials in people having surgery for hip fracture. Two assessed teams where geriatricians visited patients on orthopaedic wards. The other trials

NIHR Dissemination Centre2018

20. Should This Patient Receive Prophylactic Medication to Prevent Delirium?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Should This Patient Receive Prophylactic Medication to Prevent Delirium?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. In 2015, the American Geriatrics Society released recommendations for prevention and management of postoperative delirium, based on a systematic literature review and evaluation of nonpharmacologic and pharmacologic approaches by an expert panel. The guidelines recommend an interdisciplinary focus on nonpharmacologic measures (reorientation, medication (...) management, early mobility, nutrition, and gastointestinal motility) for prevention and consideration of this strategy for acute management. They also recommend optimizing nonopioid medication as a means to manage pain and avoiding benzodiazepines other than to treat substance withdrawal. The authors concluded that evidence to recommend antipsychotics for prevention of delirium is insufficient but that these drugs may be considered for short-term treatment in the setting of imminent harm to the patient

Annals of Internal Medicine2018