Latest & greatest articles for delirium

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Top results for delirium

121. How can delirium best be prevented and managed in older patients in hospital?

How can delirium best be prevented and managed in older patients in hospital? How can delirium best be prevented and managed in older patients in hospital? How can delirium best be prevented and managed in older patients in hospital? Holroyd-Leduc JM, Khandwala F, Sink KM CRD summary This review evaluated strategies for the prevention and management of delirium in hospitalised older patients. The authors concluded that limited evidence supported multicomponent strategies for preventing delirium (...) in such patients. The authors' conclusion reflects the evidence presented, but potential methodological limitations in the search and review processes made the reliability of this conclusion unclear. Authors' objectives To evaluate strategies for the prevention and management of delirium in hospitalised older patients. Searching MEDLINE, EMBASE and Cochrane Database of Systematic Reviews were searched for articles in English. Search dates spanned from 1950 to 2007. Search terms were reported. Reference lists

DARE.2010

122. Does this patient have delirium: value of bedside instruments

Does this patient have delirium: value of bedside instruments Does this patient have delirium: value of bedside instruments Does this patient have delirium: value of bedside instruments Wong CL, Holroyd-Leduc J, Simel DL, Straus SE CRD summary This review concluded that the choice of instrument to diagnose delirium may depend on time available and the experience of the diagnosing professional. The evidence supported use of the Confusion Assessment Method. The authors' conclusions reflected (...) the evidence presented, but the limited search strategy and reporting of quality suggest that the conclusions should be interpreted with some caution. Authors' objectives To assess the accuracy of bedside instruments in diagnosing delirium in adult patients. Searching MEDLINE (from 1950) and EMBASE (from 1980) were searched to May 2010 for articles published in English. Search terms were reported. Reference lists of retrieved articles were searched manually. Study selection Prospective studies

DARE.2010

123. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis

The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review (...) with meta-analysis Mason SE, Noel-Storr A, Ritchie CW CRD summary The authors concluded that general anaesthesia could increase the risk of postoperative cognitive dysfunction, compared with regional or combined anaesthesia, but this was not shown for delirium after surgery. This conclusion should be interpreted with caution as the outcomes varied between trials, and the differences between general, regional, and combined anaesthesia were not statistically significant. Authors' objectives To compare

DARE.2010

124. Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia: are there implications for delirium? A systematic review

Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia: are there implications for delirium? A systematic review Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia: are there implications for delirium? A systematic review Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia: are there implications for delirium? A systematic review de Jonghe A, Korevaar JC, van Munster BC, de Rooij SE CRD summary The review (...) concluded that sundowning (exacerbation of delirium during the evening or night)/agitated behaviour improved with melatonin treatment in patients with dementia. The authors’ conclusions appear overly strong given the limitations of the evidence presented. Authors' objectives To evaluate the effectiveness of melatonin treatment on circadian rhythm disturbances in patients with dementia. Searching PubMed, EMBASE, CINAHL and Cochrane Database of Systematic Reviews were searched from 1985 up to April 2009

DARE.2010

125. Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial.

Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. 21056464 2010 11 29 2010 12 08 2015 11 19 1474-547X 376 9755 2010 Nov 27 Lancet (London, England) Lancet Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised (...) trial. 1829-37 10.1016/S0140-6736(10)61855-7 Delirium is frequently diagnosed in critically ill patients and is associated with adverse outcome. Impaired cholinergic neurotransmission seems to have an important role in the development of delirium. We aimed to establish the effect of the cholinesterase inhibitor rivastigmine on the duration of delirium in critically ill patients. Patients (aged ≥18 years) who were diagnosed with delirium were enrolled from six intensive care units in the Netherlands

Lancet2010

126. Delirium: prevention, diagnosis and management

Delirium: prevention, diagnosis and management Delirium: pre Delirium: prev vention, diagnosis and ention, diagnosis and management management Clinical guideline Published: 28 July 2010 nice.org.uk/guidance/cg103 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration (...) be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Delirium: prevention, diagnosis and management (CG103) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 22Contents Contents Overview 4 Who

National Institute for Health and Clinical Excellence - Clinical Guidelines2010

127. Evidence-based practice guideline. Acute confusion/delirium.

Evidence-based practice guideline. Acute confusion/delirium. Acute confusion/delirium. | National Guideline Clearinghouse Search Sign In Username or Email * Password * Remember Me Don't have an account? Guideline Summary NGC:007208 This guideline summary has been withdrawn from NGC. Please update your bookmarks. View all withdrawn summaries in the . About NGC Guideline Summaries NGC's guidelines summaries contain information systematically derived from original guidelines. New on NGC Guideline

University of Iowa Gerontological Nursing Interventions Research Center, Research Translation and Di2009

128. Benzodiazepines for delirium.

Benzodiazepines for delirium. BACKGROUND: Delirium occurs in 30% of hospitalised patients and is associated with prolonged hospital stay and increased morbidity and mortality. The results of uncontrolled studies have been unclear, with some suggesting that benzodiazepines may be useful in controlling non-alcohol related delirium. OBJECTIVES: To determine the effectiveness and incidence of adverse effects of benzodiazapines in the treatment of non-alcohol withdrawal related delirium. SEARCH (...) to be calculated. Only "intention to treat" data were to be included. MAIN RESULTS: Only one trial satisfying the selection criteria could be identified. In this trial, comparing the effect of the benzodiazepine, lorazepam, with dexmedetomidine, a selective alpha-2-adrenergic receptor agonist, on delirium among mechanically ventilated intensive care unit patients, dexmedetomidine treatment was associated with an increased number of delirium- and coma-free days compared with lorazepam treated patients

Cochrane2009

129. Comparison of delirium assessment tools in a mixed intensive care unit

Comparison of delirium assessment tools in a mixed intensive care unit 19384206 2009 05 18 2009 06 08 2009 05 18 1530-0293 37 6 2009 Jun Critical care medicine Crit. Care Med. Comparison of delirium assessment tools in a mixed intensive care unit. 1881-5 10.1097/CCM.0b013e3181a00118 Delirium is a frequent problem in the intensive care unit (ICU) associated with poor prognosis. Delirium in the ICU is underdiagnosed by nursing and medical staff. Several detection methods have been developed (...) for use in ICU patients. The aim of this study was to compare the value of three detection methods (the Confusion Assessment Method for the ICU [CAM-ICU], the Intensive Care Delirium Screening Checklist [ICDSC] and the impression of the ICU physician with the diagnosis of a psychiatrist, neurologist, or geriatrician). Prospective study. During an 8-month period, 126 patients (mean age 62.4 years, sd 15.0; mean Acute Physiology and Chronic Health Evaluation II score 20.9, sd 7.5) admitted to a 32-bed

EvidenceUpdates2009

130. Executive function and depression as independent risk factors for postoperative delirium

Executive function and depression as independent risk factors for postoperative delirium 19326492 2009 03 26 2009 04 28 2016 11 22 1528-1175 110 4 2009 Apr Anesthesiology Anesthesiology Executive function and depression as independent risk factors for postoperative delirium. 781-7 Postoperative delirium has been associated with greater complications, medical cost, and increased mortality during hospitalization. Recent evidence suggests that preoperative executive dysfunction and depression may (...) predict postoperative delirium; however, the combined effect of these risk factors remains unknown. This study examined the association among preoperative executive function, depressive symptoms, and established clinical predictors of postoperative delirium among 998 consecutive patients undergoing major noncardiac surgery. A total of 998 patients were screened for postoperative delirium (n = 998) using the Confusion Assessment Method as well as through retrospective chart review. Patients underwent

EvidenceUpdates2009 Full Text: Link to full Text with Trip Pro

131. Measures of executive function and depression identify patients at risk for postoperative delirium

Measures of executive function and depression identify patients at risk for postoperative delirium 19326494 2009 03 26 2009 04 28 2017 02 20 1528-1175 110 4 2009 Apr Anesthesiology Anesthesiology Measures of executive function and depression identify patients at risk for postoperative delirium. 788-95 Postoperative delirium is associated with increased morbidity and mortality. Preexisting cognitive impairment and depression have been frequently cited as important risk factors (...) for this complication. This prospective cohort study was designed to determine whether individuals who perform poorly on preoperative cognitive tests and/or exhibited depressive symptoms would be at high risk for the development of postoperative delirium. One hundred nondemented patients, aged 50 yr and older, scheduled to undergo major, elective noncardiac surgery completed a preoperative test battery that included measures of global cognition, executive function, and symptoms of depression. Known preoperative

EvidenceUpdates2009 Full Text: Link to full Text with Trip Pro

132. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery

Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery 19118253 2009 01 20 2009 02 13 2016 12 03 1524-4539 119 2 2009 Jan 20 Circulation Circulation Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. 229-36 10.1161/CIRCULATIONAHA.108.795260 Delirium is a common outcome after cardiac surgery. Delirium prediction rules identify patients at risk for delirium who may benefit from targeted prevention strategies (...) , early identification, and treatment of underlying causes. The purpose of the present prospective study was to develop a prediction rule for delirium in a cardiac surgery cohort and to validate it in an independent cohort. Prospectively, cardiac surgery patients > or =60 years of age were enrolled in a derivation sample (n=122) and then a validation sample (n=109). Beginning on the second postoperative day, patients underwent a standardized daily delirium assessment, and delirium was diagnosed

EvidenceUpdates2009 Full Text: Link to full Text with Trip Pro

133. Benzodiazepines for delirium.

Benzodiazepines for delirium. BACKGROUND: Delirium occurs in 30% of hospitalised patients and is associated with prolonged hospital stay and increased morbidity and mortality. The results of uncontrolled studies have been unclear, with some suggesting that benzodiazepines may be useful in controlling non-alcohol related delirium. OBJECTIVES: To determine the effectiveness and incidence of adverse effects of benzodiazapines in the treatment of non-alcohol withdrawal related delirium. SEARCH (...) to be calculated. Only "intention to treat" data were to be included. MAIN RESULTS: Only one trial satisfying the selection criteria could be identified. In this trial, comparing the effect of the benzodiazepine, lorazepam, with dexmedetomidine, a selective alpha-2-adrenergic receptor agonist, on delirium among mechanically ventilated intensive care unit patients, dexmedetomidine treatment was associated with an increased number of delirium- and coma-free days compared with lorazepam treated patients

Cochrane2009

135. Pharmacological management of delirium in hospitalized adults: a systematic evidence review

Pharmacological management of delirium in hospitalized adults: a systematic evidence review Pharmacological management of delirium in hospitalized adults: a systematic evidence review Pharmacological management of delirium in hospitalized adults: a systematic evidence review Campbell N, Boustani MA, Ayub A, Fox GC, Munger SL, Ott C, Guzman O, Farber M, Ademuyiwa A, Singh R CRD summary This review assessed use of pharmacological agents for managing and preventing delirium. The conclusions (...) that second-generation antipsychotics appeared to offer no advantage over haloperidol in managing delirium and further research was required in both management and prevention of delirium was reasonable given methodological limitations of many of the included studies. Authors' objectives To evaluate the efficacy and safety of pharmacologic interventions targeting either prevention or management of delirium. Searching MEDLINE via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL

DARE.2009

136. Agitation and Delirium at the End of Life: "We Couldn't Manage Him"

Agitation and Delirium at the End of Life: "We Couldn't Manage Him" Delirium is the most common neuropsychiatric complication experienced by patients with advanced illness, occurring in up to 85% of patients in the last weeks of life. Using the case of Mr L, a 59-year-old man with metastatic lung cancer who developed an agitated delirium in the last week of life, we review the evaluation and management of delirium near the end of life. Although some studies have identified agitation (...) as a central feature of delirium in 13% to 46% of patients, other studies have found up to 80% of patients near the end of life develop a hypoactive, nonagitated delirium. Both the agitated (hyperactive) and nonagitated (hypoactive) forms of delirium are harbingers of impending death and are associated with increased morbidity in patients who are terminally ill, causing distress for patients, family members, and staff. Delirium is a sign of significant physiological disturbance, usually involving multiple

JAMA2008

137. Pediatric illness severity measures predict delirium in a pediatric intensive care unit

Pediatric illness severity measures predict delirium in a pediatric intensive care unit 18496355 2008 06 03 2008 06 17 2008 06 03 1530-0293 36 6 2008 Jun Critical care medicine Crit. Care Med. Pediatric illness severity measures predict delirium in a pediatric intensive care unit. 1933-6 10.1097/CCM.0b013e31817cee5d Delirium in children is a serious but understudied neuropsychiatric disorder. So there is little to guide the clinician in terms of identifying those at risk. To study (...) , in a pediatric intensive care unit (PICU), the predictive power of widely used generic pediatric mortality scoring systems in relation to the occurrence of pediatric delirium (PD). Four-year prospective observational study, 2002-2005. Predictors used were the Pediatric Index of Mortality (PIM) and Pediatric Risk of Mortality (PRISM II). A tertiary 8-bed PICU in The Netherlands. 877 critically ill children who were acutely, nonelectively, and consecutively admitted. Pediatric delirium. Out of 877 children

EvidenceUpdates2008

138. Cognitive disorders and HIV/AIDS: HIV-associated dementia and delirium.

Cognitive disorders and HIV/AIDS: HIV-associated dementia and delirium. Cognitive disorders and HIV/AIDS: HIV-associated dementia and delirium. | National Guideline Clearinghouse Search Sign In Username or Email * Password * Remember Me Don't have an account? Guideline Summary NGC:006469 This guideline summary has been withdrawn from NGC. Please update your bookmarks. View all withdrawn summaries in the . About NGC Guideline Summaries NGC's guidelines summaries contain information

New York State Department of Health2008

139. Cholinesterase inhibitors for delirium.

Cholinesterase inhibitors for delirium. BACKGROUND: Delirium is now the preferred term to describe acute confusional states. It is experienced by 10 to 30% of all hospital inpatients. Delirium is potentially reversible and is related to several adverse outcomes, including increased hospital length of stay, poor functional status, persistent cognitive impairment, need for institutional care and probably mortality. Disruption of the cholinergic system has been proposed as a key mechanism (...) of delirium. Cholinesterase inhibitors enhance the cholinergic system and there have been reports that they might be beneficial in treating delirium. OBJECTIVES: To assess the efficacy and safety of cholinesterase inhibitors in the treatment of delirium. SEARCH STRATEGY: The Cochrane Dementia and Cognitive Improvement Group's Register of Clinical Trials (which includes records from MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, LILACS and other databases) was searched for relevant randomised controlled

Cochrane2008

140. Drug treatment of delirium: past, present and future

Drug treatment of delirium: past, present and future Drug treatment of delirium: past, present and future Drug treatment of delirium: past, present and future Bourne RS, Tahir TA, Borthwick M, Sampson EL CRD summary This review concluded that the efficacy rates between typical and atypical antipsychotics for the treatment of delirium were similar, but the latter was associated with fewer extrapyramidal adverse effects. In view of a lack of details on study quality and other methodological (...) concerns in the review methods, the authors' conclusions may not be reliable. Authors' objectives To assess the efficacy and safety of drug therapy for the treatment or prevention of delirium. Searching The following databases were searched for English language studies from 1967 to March 2008: MEDLINE, EMBASE, PsycINFO and the Cochrane Library. Search terms were reported. Conference proceedings from Academy of Psychosomatic Medicine, European Delirium Association and critical care (European Society

DARE.2008