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Original Articles
Nursing
The effects of environmental interventions for delirium in critically ill surgical patients
Hak-Jae Lee, Yoon-Joong Jung, Nak-Joon Choi, Suk-Kyung Hong
Acute Crit Care. 2023;38(4):479-487.   Published online November 28, 2023
DOI: https://doi.org/10.4266/acc.2023.00990
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  • 53 Download
AbstractAbstract PDF
Background
Delirium occurs at high rates among patients in intensive care units and increases the risk of morbidity and mortality. The purpose of this study was to investigate the effects of environmental interventions on delirium.
Methods
This prospective cohort study enrolled 192 patients admitted to the surgical intensive care unit (SICU) during the pre-intervention (June 2013 to October 2013) and post-intervention (June 2014 to October 2014) periods. Environmental interventions involved a cognitive assessment, an orientation, and a comfortable environment including proper sleep conditions. The primary outcomes were the prevalence, duration, and onset of delirium.
Results
There were no statistically significant differences in incidence rate, time of delirium onset, general characteristics, and mortality between the pre-intervention and post-intervention groups. The durations of delirium were 14.4±19.1 and 7.7±7.3 days in the pre-intervention and post-intervention groups, respectively, a significant reduction (P=0.027). The lengths of SICU stay were 20.0±22.9 and 12.6±8.7 days for the pre-intervention and post-intervention groups, respectively, also a significant reduction (P=0.030).
Conclusions
The implementation of an environmental intervention program reduced the duration of delirium and length of stay in the SICU for critically ill surgical patients.
Pediatrics
Implementation and effectiveness of a delirium care protocol in Thai critically ill children
Chanapai Chaiyakulsil, Thananya Thadahirunchot
Acute Crit Care. 2023;38(4):488-497.   Published online November 28, 2023
DOI: https://doi.org/10.4266/acc.2023.00045
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  • 31 Download
AbstractAbstract PDF
Background
Delirium in critically ill children can result in long-term morbidity. Our main objectives were to evaluate the effectiveness of a new protocol on the reduction, prevalence, and duration of delirium and to identify associated risk factors.
Methods
The effectiveness of the protocol was evaluated by a chart review in all critically ill children aged 1 month to 15 years during the study period. A Cornell Assessment of Pediatric Delirium score ≥9 was considered positive for delirium. Data on delirium prevalence and duration from the pre-implementation and post-implementation phases were compared. Univariate and multivariate analyses were used to identify the risk factors of delirium.
Results
A total of 120 children was analyzed (58 children in the pre-implementation group and 62 children in the post-implementation group). Fifty children (41.7%) screened positive for delirium. Age less than 2 years, delayed development, use of mechanical ventilation, and pediatric intensive care unit (PICU) stay >7 days were significantly associated with delirium. The proportion of children screened positive was not significantly different after the implementation (before, 39.7% vs. after, 43.5%; P=0.713). Subgroup analyses revealed a significant reduction in the duration of delirium in children with admission diagnosis of cardiovascular problems and after cardiothoracic surgery.
Conclusions
The newly implemented protocol was able to reduce the duration of delirium in children with admission diagnosis of cardiovascular problems and after cardiothoracic surgery. More studies should be conducted to reduce delirium to prevent long-term morbidity after PICU discharge.
Neurology
The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units
Joong-Yub Kim, Hyo Jin Lee, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee, Tae Yun Park
Acute Crit Care. 2022;37(3):407-414.   Published online July 5, 2022
DOI: https://doi.org/10.4266/acc.2022.00164
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  • 195 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
In critically ill patients, the most common manifestation of brain dysfunction is delirium, which is independently associated with higher morbidity and mortality. While electrolyte imbalance is one of the precipitating factors, the impact of hypomagnesemia on the incidence of delirium remains unknown.
Methods
We retrospectively analyzed patients admitted to the medical intensive care unit (ICU) of a tertiary referral center between January and June 2020. Patients with ICU stay ≥48 hours and aged 40–85 years were included. The primary outcome was cumulative incidence of delirium in the ICU. Patients were divided into two groups based on serum magnesium level at ICU admission. Multivariable Cox proportional hazards regression analysis was performed, and covariates were selected using the least absolute shrinkage and selection operator (LASSO) method.
Results
A total of 109 patients included 43 (39.4%) women and had a median age of 69.0 years (interquartile range [IQR], 60.0–76.0 years). The median magnesium level was 1.7 mg/dl (IQR, 1.5–1.9 mg/dl), and the cumulative incidence of delirium was 32.1% (35 patients). Hypomagnesemia was independently associated with delirium (adjusted hazard ratio [aHR], 2.12; 95% confidence interval [CI], 1.03–4.38), along with prior use of immunosuppressants (aHR, 3.08; 95% CI, 1.46–6.48) or benzodiazepines (aHR, 4.02; 95% CI, 1.54–10.50), body mass index (aHR, 0.93; 95% CI, 0.84–1.02), and alcohol history (aHR, 1.68; 95% CI, 0.74–3.80).
Conclusions
In critically ill adults, hypomagnesemia increases the risk of delirium by more than two-fold compared to patients with normal magnesium level.

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Citations to this article as recorded by  
  • Hypomagnesemia and incident delirium in hospitalized older persons
    Virginia Boccardi, Sara Ercolani, Rocco Serra, Valentina Bubba, Alessandro Piccolo, Michela Scamosci, Alfredo Villa, Carmelinda Ruggiero, Patrizia Mecocci
    Aging Clinical and Experimental Research.2023; 35(4): 847.     CrossRef
Neurology
Cytokine profiles in intensive care unit delirium
Ryan J. Smith, Christian Lachner, Vijay P. Singh, Shubham Trivedi, Biswajit Khatua, Rodrigo Cartin-Ceba
Acute Crit Care. 2022;37(3):415-428.   Published online June 20, 2022
DOI: https://doi.org/10.4266/acc.2021.01508
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  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Neuroinflammation causing disruption of the blood-brain barrier and immune cell extravasation into the brain parenchyma may cause delirium; however, knowledge of the exact pathophysiologic mechanism remains incomplete. The purpose of our study was to determine whether cytokine profiles differ depending on whether delirium occurs in the setting of sepsis, coronavirus disease 2019 (COVID-19), or recent surgery.
Methods
This prospective observational cohort study involved 119 critically ill patients admitted to a multidisciplinary intensive care unit (ICU) during 2019 and 2020. Delirium was identified using the validated confusion assessment method for the ICU. Multiple delirium risk factors were collected daily including clinical characteristics, hospital course, lab values, vital signs, surgical exposure, drug exposure, and COVID-19 characteristics. Serums samples were collected within 12 hours of ICU admission and cytokine levels were measured.
Results
The following proinflammatory cytokines were elevated in our delirium population: tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-18, C-C motif ligand (CCL) 2, CCL3, C-X-C motif chemokine ligand (CXCL)1, CXCL10, IL-8, IL-1 receptor antagonist, and IL-10. Analysis of relative cytokine levels in those patients that developed delirium in the setting of sepsis, COVID-19, and recent surgery showed elevations of CCL2, CXCL10, and TNF-α in both the sepsis and COVID-19 group in comparison to the postsurgical population. In the postsurgical group, granulocyte colony-stimulating factor was elevated and CXCL10 was decreased relative to the opposing groups.
Conclusions
We identify several cytokines and precipitating factors known to be associated with delirium. However, our study suggests that the cytokine profile associated with delirium is variable and contingent upon delirium precipitating factors.

Citations

Citations to this article as recorded by  
  • Association of postoperative delirium with serum and cerebrospinal fluid proteomic profiles: a prospective cohort study in older hip fracture patients
    Lucía Lozano-Vicario, Ángel Javier Muñoz-Vázquez, Robinson Ramírez-Vélez, Arkaitz Galbete-Jiménez, Joaquín Fernández-Irigoyen, Enrique Santamaría, Bernardo Abel Cedeno-Veloz, Fabricio Zambom-Ferraresi, Barbara C. Van Munster, José Ramón Ortiz-Gómez, Ángel
    GeroScience.2024;[Epub]     CrossRef
  • Association of peripheral B cells and delirium: combined single-cell sequencing and Mendelian randomization analysis
    Siyou Tan, Sining Pan, Lai Wei, Wenyan Chen, Bingbing Pan, Gaoyin Kong, Jing Chen, Yubo Xie
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Brain injury biomarkers do not predict delirium in acutely ill older patients: a prospective cohort study
    Júlio César Garcia de Alencar, Flávia Barreto Garcez, Agnes Araujo Sardinha Pinto, Lucas Oliveira Junqueira e Silva, Lucas de Moraes Soler, Shirley Steffany Muñoz Fernandez, Victor Van Vaisberg, Luz Marina Gomez Gomez, Sandra Maria Lima Ribeiro, Thiago Ju
    Scientific Reports.2023;[Epub]     CrossRef
  • Systemic interleukin-6 inhibition ameliorates acute neuropsychiatric phenotypes in a murine model of acute lung injury
    Faizan Anwar, Nicklaus A. Sparrow, Mohammad Harun Rashid, Gena Guidry, Michael M. Gezalian, Eric J. Ley, Maya Koronyo-Hamaoui, Itai Danovitch, E. Wesley Ely, S. Ananth Karumanchi, Shouri Lahiri
    Critical Care.2022;[Epub]     CrossRef
Guideline
Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
Acute Crit Care. 2022;37(1):1-25.   Published online February 28, 2022
DOI: https://doi.org/10.4266/acc.2022.00094
Correction in: Acute Crit Care 2023;38(1):149
  • 14,481 View
  • 1,533 Download
  • 10 Web of Science
  • 20 Crossref
AbstractAbstract PDF
We revised and expanded the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).” We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding. The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.

Citations

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  • Potentially inappropriate medications with older people in intensive care and associated factors: a historic cohort study
    Karina Sichieri, Danilo Donizetti Trevisan, Ricardo Luís Barbosa, Silvia Regina Secoli
    Sao Paulo Medical Journal.2024;[Epub]     CrossRef
  • Psychiatric Consults Associated With Longer Length of Stay in Trauma Patients—A Retrospective Study
    Sanjay Balijepalli, Kathryn Mansuri, Cindy Gonzalez, Oveys Mansuri
    Journal of Surgical Research.2024; 293: 46.     CrossRef
  • Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality
    Adrienne E. van der Hoeven, Denise Bijlenga, Ernst van der Hoeven, Mink S. Schinkelshoek, Floor W. Hiemstra, Laura Kervezee, David J. van Westerloo, Rolf Fronczek, Gert Jan Lammers
    Intensive and Critical Care Nursing.2024; 81: 103603.     CrossRef
  • Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool
    Luthfi Fauzy Asriyanto, Nur Chayati
    International Journal of Nursing Sciences.2024; 11(1): 113.     CrossRef
  • Postoperative Psychoses in Patients with Brain Gliomas
    O. S. Zaitsev, N. P. Ilyaev, O. A. Maksakova
    Psikhiatriya.2024; 21(7): 65.     CrossRef
  • Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
    Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
    Acute and Critical Care.2024; 39(1): 1.     CrossRef
  • Prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit: A retrospective study
    Jeong-Ok Ryu, Gwi-Ryung Son Hong
    Journal of Korean Gerontological Nursing.2024; 26(1): 113.     CrossRef
  • Factors that influence critical care nurses’ management of sedation for ventilated patients in critical care: A qualitative study
    Danielle Macpherson, Anastasia Hutchinson, Melissa J. Bloomer
    Intensive and Critical Care Nursing.2024; 83: 103685.     CrossRef
  • End‐of‐life care in the intensive care unit
    M. Tanaka Gutiez, N. Efstathiou, R. Innes, V. Metaxa
    Anaesthesia.2023; 78(5): 636.     CrossRef
  • The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea
    Dong-gon Hyun, Jee Hwan Ahn, Ha-Yeong Gil, Chung Mo Nam, Choa Yun, Jae-Myeong Lee, Jae Hun Kim, Dong-Hyun Lee, Ki Hoon Kim, Dong Jung Kim, Sang-Min Lee, Ho-Geol Ryu, Suk-Kyung Hong, Jae-Bum Kim, Eun Young Choi, JongHyun Baek, Jeoungmin Kim, Eun Jin Kim, T
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • The relationship between the PRE-DELIRIC score and the prognosis in COVID-19 ICU patients
    Bilge Banu Taşdemir Mecit
    Journal of Surgery and Medicine.2023; 7(5): 343.     CrossRef
  • Systemic Nonsteroidal Anti-Inflammatories for Analgesia in Postoperative Critical Care Patients: A Systematic Review and Meta-Analysis of Randomized Control Trials
    Chen Hsiang Ma, Kimberly B. Tworek, Janice Y. Kung, Sebastian Kilcommons, Kathleen Wheeler, Arabesque Parker, Janek Senaratne, Erika Macintyre, Wendy Sligl, Constantine J. Karvellas, Fernando G. Zampieri, Demetrios Jim Kutsogiannis, John Basmaji, Kimberle
    Critical Care Explorations.2023; 5(7): e0938.     CrossRef
  • Pain Control and Sedation in Neuro Intensive Critical Unit
    Soo-Hyun Park, Yerim Kim, Yeojin Kim, Jong Seok Bae, Ju-Hun Lee, Wookyung Kim, Hong-Ki Song
    Journal of the Korean Neurological Association.2023; 41(3): 169.     CrossRef
  • Preoperative Anxiety and Its Postoperative Associated Factors in Patients Receiving Post Anesthetic Recovery Care at Surgical Intensive Care Unit
    Yul Ha Lee, Hye-Ja Park
    Journal of Health Informatics and Statistics.2023; 48(3): 267.     CrossRef
  • Diagnostic Value of the Bispectral Index to Assess Sleep Quality after Elective Surgery in Intensive Care Unit
    Naricha Chirakalwasan, Pongpol Sirilaksanamanon, Thammasak Thawitsri, Somrat Charuluxananan
    Indian Journal of Critical Care Medicine.2023; 27(11): 795.     CrossRef
  • Sedation of patients in intensive care units. Guidelines
    V.I. Potievskaya, I.B. Zabolotskikh, I.E. Gridchik, A.I. Gritsan, A.A. Eremenko, I.A. Kozlov, A.L. Levit, V.A. Mazurok, I.V. Molchanov
    Anesteziologiya i reanimatologiya.2023; (5): 6.     CrossRef
  • Sedation for Patients with Sepsis: Towards a Personalised Approach
    José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
    Journal of Personalized Medicine.2023; 13(12): 1641.     CrossRef
  • Performance, Knowledge, and Barrier Awareness of Medical Staff Regarding the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Critical Care Patients: A Cross-Sectional Study
    Hyo-Geun Song, Duckhee Chae, Sung-Hee Yoo
    Korean Journal of Adult Nursing.2023; 35(4): 379.     CrossRef
  • ICU-Induced Disability Persists With or Without COVID-19—This Is a Call for F to A Bundle Action*
    Heidi Engel
    Critical Care Medicine.2022; 50(11): 1665.     CrossRef
  • Actigraphy-Based Assessment of Sleep Parameters in Intensive Care Unit Patients Receiving Respiratory Support Therapy
    Jiyeon Kang, Yongbin Kwon
    Journal of Korean Critical Care Nursing.2022; 15(3): 115.     CrossRef
Original Article
Neurology
Association of natural light exposure and delirium according to the presence or absence of windows in the intensive care unit
Hyo Jin Lee, Eunhye Bae, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2021;36(4):332-341.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.00556
  • 5,927 View
  • 194 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFSupplementary Material
Background
Patients in the intensive care unit (ICU) have increased risks of delirium, which is associated with worse outcomes. As pharmacologic treatments for delirium are ineffective, prevention is important. Nonpharmacologic preventive strategies include exposure to natural light and restoring circadian rhythm. We investigated the effect of exposure to natural light through windows on delirium in the ICU.
Methods
This retrospective cohort study assessed all patients admitted to the medical ICU of a university-affiliated hospital between January and June 2020 for eligibility. The ICU included 12 isolation rooms, six with and six without windows. Patients with ICU stays of >48 hours were included and were divided into groups based on their admission to a single room with (window group) or without windows (windowless group). The primary outcome was the cumulative incidence of delirium. The secondary outcomes were the numbers of delirium- and mechanical ventilation-free days, ICU and hospital length of stay, and in-ICU and 28-day mortalities.
Results
Of the 150 included patients (window group: 83 [55.3%]; windowless group: 67 [44.7%]), the cumulative incidence of delirium was significantly lower in the window group than in the windowless group (21.7% vs. 43.3%; relative risk, 1.996; 95% confidence interval [CI], 1.220–3.265). Other secondary outcomes did not differ between groups. Admission to a room with a window was independently associated with a decreased risk of delirium (adjusted odds ratio, 0.318; 95% CI, 0.125–0.805).
Conclusions
Exposure to natural light through windows was associated with a lower incidence of delirium in the ICU.

Citations

Citations to this article as recorded by  
  • Geriatric Psychiatric Emergencies
    Michelle A. Fischer, Monica Corsetti
    Emergency Medicine Clinics of North America.2024; 42(1): 135.     CrossRef
  • There’s No Place Like Home: Delirium as a Barrier in Geriatric Trauma
    Abdoulaziz Toure, Roshan Tadi, Mitchell Meagher, Catherine Ting Brown, Hoi Lam, Samantha LaRosa, Launick Saint-Fort, Huda Syed, Nathaniel Harshaw, Katherine Moore, Neelofer Sohail, Lindsey L. Perea
    Journal of Surgical Research.2024; 293: 89.     CrossRef
  • The Influence of Exposure to Nature on Inpatient Hospital Stays: A Scoping Review
    Keegan Guidolin, Flora Jung, Sarah Hunter, Han Yan, Marina Englesakis, Stephen Verderber, Sami Chadi, Fayez Quereshy
    HERD: Health Environments Research & Design Journal.2024;[Epub]     CrossRef
  • Four Decades of Intensive Care Unit Design Evolution and Thoughts for the Future
    Neil A. Halpern, Elizabeth Scruth, Michelle Rausen, Diana Anderson
    Critical Care Clinics.2023; 39(3): 577.     CrossRef
  • Improving healthcare value: integrating medical practitioners into hospital design in developing countries
    Carlos Machhour Noujeim
    Healthcare in Low-resource Settings.2023;[Epub]     CrossRef
  • Evaluation of the sensory environment in a large tertiary ICU
    Oystein Tronstad, Dylan Flaws, Sue Patterson, Robert Holdsworth, Veronica Garcia-Hansen, Francisca Rodriguez Leonard, Ruth Ong, Stephanie Yerkovich, John F. Fraser
    Critical Care.2023;[Epub]     CrossRef
  • 2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
    Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
    Acute and Critical Care.2022; 37(1): 1.     CrossRef
  • Post-acute delirium of COVID-19 infection: Report of two cases
    Dai-Chun Chi, Chih-Pang Chu, TienWei Yang, Hu-Ming Chang
    Taiwanese Journal of Psychiatry.2022; 36(1): 44.     CrossRef
  • The future of intensive care: delirium should no longer be an issue
    Katarzyna Kotfis, Irene van Diem-Zaal, Shawniqua Williams Roberson, Marek Sietnicki, Mark van den Boogaard, Yahya Shehabi, E. Wesley Ely
    Critical Care.2022;[Epub]     CrossRef
  • The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units
    Joong-Yub Kim, Hyo Jin Lee, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee, Tae Yun Park
    Acute and Critical Care.2022; 37(3): 407.     CrossRef
Review Articles
Infection
Evolution of COVID-19 management in critical care: review and perspective from a hospital in the United Kingdom
Avinash Kumar Jha, Sudhindra Gurunath Kulkarni
Acute Crit Care. 2021;36(1):1-14.   Published online February 26, 2021
DOI: https://doi.org/10.4266/acc.2020.00864
  • 7,010 View
  • 400 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract PDF
The unexpected emergence and spread of coronavirus disease 2019 (COVID-19) has been pandemic, with long-lasting effects, and unfortunately, it does not seem to have ended. Integrating advanced planning, strong teamwork, and clinical management have been both essential and rewarding during this time. Understanding the new concepts of this novel disease and accommodating them into clinical practice is an ongoing process, ultimately leading to advanced and highly specific treatment modalities. We conducted a literature review through PubMed, Europe PMC, Scopus, and Google Scholar to incorporate the most updated therapeutic principles. This article provides a concise and panoramic view of the cohort of critically ill patients admitted to the intensive care unit. We conclude that COVID-19 management includes low tidal volume ventilation, early proning, steroids, and a high suspicion for secondary bacterial/fungal infections. Lung ultrasound is emerging as a promising tool in assessing the clinical response. Managing non-clinical factors such as staff burnout, communication/consent issues, and socio-emotional well-being is equally important.

Citations

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  • Feasibility of Ultrasound-Guided, Peripherally Inserted Central Catheter Placement at the Bedside in a Communicable-Disease Isolation Unit
    Kyoung Won Yoon, Wongook Wi, Moon Suk Choi, Eunmi Gil, Chi-Min Park, Keesang Yoo
    Journal of Personalized Medicine.2023; 13(5): 863.     CrossRef
  • Implementation of an Emergency Department–Embedded Infusion Center for the Administration of Monoclonal Antibody Therapy in Patients With Early COVID-19 Infection
    Julie Graham, Christina Ballejos, Danisha Jenkins, Christina Kelley
    Journal of Infusion Nursing.2022; 45(1): 41.     CrossRef
  • Editorial: cardiovascular anaesthesiology
    Anne D. Cherry, Mark Nelson, Nirvik Pal
    Current Opinion in Anaesthesiology.2022; 35(1): 1.     CrossRef
  • Dietetic-Led Nutrition Interventions in Patients with COVID-19 during Intensive Care and Ward-Based Rehabilitation: A Single-Center Observational Study
    Ella Terblanche, Jessica Hills, Edie Russell, Rhiannon Lewis, Louise Rose
    Nutrients.2022; 14(5): 1062.     CrossRef
  • Mortality of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation During the Three Epidemic Waves
    Christophe Beyls, Pierre Huette, Christophe Viart, Benjamin Mestan, Guillaume Haye, Mathieu Guilbart, Michael Bernasinski, Patricia Besserve, Florent Leviel, Alejandro Witte Pfister, Florence De Dominicis, Vincent Jounieaux, Pascal Berna, Hervé Dupont, Os
    ASAIO Journal.2022; 68(12): 1434.     CrossRef
  • Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
    Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
    Acute and Critical Care.2021; 36(3): 223.     CrossRef
Neurology
Prevention and management of delirium in critically ill adult patients in the intensive care unit: a review based on the 2018 PADIS guidelines
Seung Yong Park, Heung Bum Lee
Acute Crit Care. 2019;34(2):117-125.   Published online April 17, 2019
DOI: https://doi.org/10.4266/acc.2019.00451
  • 20,913 View
  • 1,346 Download
  • 40 Web of Science
  • 41 Crossref
AbstractAbstract PDF
Delirium is an acute, confusional state characterized by altered consciousness and a reduced ability to focus, sustain, or shift attention. It is associated with a number of complex underlying medical conditions and can be difficult to recognize. Many critically ill patients (e.g., up to 80% of patients in the intensive care unit [ICU]) experience delirium due to underlying medical or surgical health problems, recent surgical or other invasive procedures, medications, or various noxious stimuli (e.g., underlying psychological stressors, mechanical ventilation, noise, light, patient care interactions, and drug-induced sleep disruption or deprivation). Delirium is associated with a longer duration of mechanical ventilation and ICU admittance as well as an increased risk of death, disability, and long-term cognitive dysfunction. Therefore, the early recognition of delirium is important and ICU medical staff should devote careful attention to both watching for the occurrence of delirium and its prevention and management. This review presents a brief overview of delirium and an update of the literature with reference to the 2018 Society of Critical Care Medicine Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.

Citations

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  • Precision Anesthesia in 2050
    Frederick H. Kuo, Brant H. Tudor, Geoffrey M. Gray, Luis M. Ahumada, Mohamed A. Rehman, Scott C. Watkins
    Anesthesia & Analgesia.2024; 138(2): 326.     CrossRef
  • Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study
    Öznur Erbay Dalli, Nermin Kelebek Girgin, Ferda Kahveci
    Journal of Clinical Nursing.2023; 32(1-2): 96.     CrossRef
  • Sustained adherence to a delirium guideline five years after implementation in an intensive care setting: A retrospective cohort study
    Marlies van Bochove-Waardenburg, Mathieu van der Jagt, Janneke de Man-van Ginkel, Erwin Ista
    Intensive and Critical Care Nursing.2023; 76: 103398.     CrossRef
  • Impact of critical care pharmacist‐led interventions on pain, agitation, and delirium in mechanically ventilated adults: A systematic review
    Mitchell S. Buckley, Russel J. Roberts, Melanie J. Yerondopoulos, Audrey K. Bushway, Grace C. Korkames, Sandra L. Kane‐Gill
    JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2023; 6(9): 1041.     CrossRef
  • Delirium in the intensive care unit: a narrative review
    Stefania Renzi, Nicola Gitti, Simone Piva
    Journal of Gerontology and Geriatrics.2023; 71(1): 22.     CrossRef
  • Delirio y su relación con la supervivencia en pacientes geriátricos con neumonía grave por SARS-CoV-2 en un hospital de tercer nivel de atención en México
    Cynthia Daniela Bazán Acevedo, Edgar Fernández Muñoz, Netzahualcóyotl González Pérez, Lilia López Carrillo
    Medicina Crítica.2023; 37(1): 35.     CrossRef
  • Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial
    Gülşen Kiliç, Sultan Kav
    Nursing in Critical Care.2023; 28(5): 698.     CrossRef
  • Yoğun Bakım Deliryumunun Erken Tespitinde Rekalibre PRE-DELIRIC Modelinin Prospektif Değerlendirilmesi
    Öznur ERBAY DALLI, Gülbahar ÇALIŞKAN, Yasemin YILDIRIM, Nermin KELEBEK GİRGİN
    Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(1): 55.     CrossRef
  • Still WALKing-FOR: 2-year sustainability of the ‘WALK FOR’ intervention
    Efrat Gil, Anna Zisberg, Efrat Shadmi, Nurit Gur-Yaish, Ksenya Shulyaev, Yehudith Chayat, Maayan Agmon
    Age and Ageing.2023;[Epub]     CrossRef
  • Optimization of Care for the Elderly Surgical Emergency Patient
    Rachel Lynne Warner, Nadia Iwanyshyn, Donald Johnson, David J. Skarupa
    Surgical Clinics of North America.2023; 103(6): 1253.     CrossRef
  • Identification and Best Practice Management of Comorbid Geri-Psych Conditions in Critical Care
    Noel Koller-Ditto
    Critical Care Nursing Clinics of North America.2023; 35(4): 481.     CrossRef
  • Inclusion of frailty improved performance of delirium prediction for elderly patients in the cardiac intensive care unit (D-FRAIL): A prospective derivation and external validation study
    Rongrong Guo, Shan Zhang, Saiying Yu, Xiangyu Li, Xinju Liu, Yanling Shen, Jinling Wei, Ying Wu
    International Journal of Nursing Studies.2023; 147: 104582.     CrossRef
  • Motion Detectors as Additional Monitoring Devices in the Intensive Care Unit—A Proof-of-Concept Study
    Gülmisal Güder, Eva von Rein, Thomas Flohr, Dirk Weismann, Dominik Schmitt, Stefan Störk, Stefan Frantz, Vincent Kratzer, Christian Kendi
    Applied Sciences.2023; 13(16): 9319.     CrossRef
  • Analytical Review of Unplanned Extubation in Intensive Care Units and Recommendation on Multidisciplinary Preventive Approaches
    Antonious Anis, Ravi Patel, Maged A Tanios
    Journal of Intensive Care Medicine.2023;[Epub]     CrossRef
  • The risk factors of postoperative cognitive dysfunction in patients undergoing carotid endarterectomy: an updated meta-analysis
    Jinhua He, Ran Duan, Peng Qiu, Huanhuan Zhang, Meng Zhang, Meinv Liu, Xiaoqian Wu, Jianli Li
    Journal of Cardiothoracic Surgery.2023;[Epub]     CrossRef
  • Sedation for Patients with Sepsis: Towards a Personalised Approach
    José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
    Journal of Personalized Medicine.2023; 13(12): 1641.     CrossRef
  • Le delirium, un syndrome mal connu
    Jean-Pierre Bénézech
    La Revue de l'Infirmière.2022; 71(277): 42.     CrossRef
  • Associations of Smoking With Delirium and Opioid Use in Older Adults With Traumatic Hip Fracture
    Kristin Salottolo, Richard Meinig, Landon Fine, Michael Kelly, Robert Madayag, Francie Ekengren, Allen Tanner, David Bar-Or
    JAAOS: Global Research and Reviews.2022;[Epub]     CrossRef
  • O papel do enfermeiro na prevenção do delirium no paciente adulto/idoso crítico
    Cláudia Oliveira, Cátia Filipa Garnacho Martins Nobre, Rita Margarida Dourado Marques, Maria Manuela Madureira Lebre Mendes, Patrícia Cruz Pontífice Sousa
    Revista Cuidarte.2022;[Epub]     CrossRef
  • Predictors of sedation period for critical illness patients focusing on early rehabilitation on the bed
    Yosuke Morimoto, Tsubasa Watanabe, Masato Oikawa, Masatoshi Hanada, Motohiro Sekino, Tetsuya Hara, Ryo Kozu
    Scientific Reports.2022;[Epub]     CrossRef
  • The Age-adjusted Charlson Comorbidity Index predicts post-operative delirium in the elderly following thoracic and abdominal surgery: A prospective observational cohort study
    Jing Liu, Jianli Li, Jinhua He, Huanhuan Zhang, Meinv Liu, Junfang Rong
    Frontiers in Aging Neuroscience.2022;[Epub]     CrossRef
  • The Effects of Pain, Agitation, Delirium, Immobility, and Sleep Disruption Education on Novice Nurses in Adult Intensive Care Units
    Szu-Ying Lee, Chieh-Yu Liu, Te-Yu Wu
    Healthcare.2022; 10(8): 1538.     CrossRef
  • Pain Assessment with the BPS and CCPOT Behavioral Pain Scales in Mechanically Ventilated Patients Requiring Analgesia and Sedation
    Katarzyna Wojnar-Gruszka, Aurelia Sega, Lucyna Płaszewska-Żywko, Stanisław Wojtan, Marcelina Potocka, Maria Kózka
    International Journal of Environmental Research and Public Health.2022; 19(17): 10894.     CrossRef
  • Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory
    Jiyeon Kang, Minhui Kim
    Journal of Korean Critical Care Nursing.2022; 15(3): 37.     CrossRef
  • Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19
    Mari Tobita, Shan-Pin Fanchiang, Aida Saldivar, Sarah Taylor, Barry Jordan
    Archives of Rehabilitation Research and Clinical Translation.2022; 4(4): 100234.     CrossRef
  • Effects of uncomfortable care and histamine H2-antagonists on delirium in acute stroke: A propensity score analysis
    Tomoki Nakamizo, Toshie Kanda, Yosuke Kudo, Eriko Sugawara, Erina Hashimoto, Ayana Okazaki, Makoto Usuda, Toru Nagai, Hiroshi Hara, Ken Johkura
    Journal of the Neurological Sciences.2021; 420: 117251.     CrossRef
  • Critical Care Considerations for Damage Control in a Trauma Patient
    Shannon Gaasch
    AACN Advanced Critical Care.2021; 32(1): 64.     CrossRef
  • Development and Validation of a Clinical Prediction Model for Sleep Disorders in the ICU: A Retrospective Cohort Study
    Yun Li, Lina Zhao, Chenyi Yang, Zhiqiang Yu, Jiannan Song, Qi Zhou, Xizhe Zhang, Jie Gao, Qiang Wang, Haiyun Wang
    Frontiers in Neuroscience.2021;[Epub]     CrossRef
  • Delirium and Associated Length of Stay and Costs in Critically Ill Patients
    Claudia Dziegielewski, Charlenn Skead, Toros Canturk, Colleen Webber, Shannon M. Fernando, Laura H. Thompson, Madison Foster, Vanja Ristovic, Peter G. Lawlor, Dipayan Chaudhuri, Chintan Dave, Brent Herritt, Shirley H. Bush, Salmaan Kanji, Peter Tanuseputr
    Critical Care Research and Practice.2021; 2021: 1.     CrossRef
  • Effects of a simulation‐based education programme on delirium care for critical care nurses: A randomized controlled trial
    Mu‐Hsing Ho, Lee‐Fen Yu, Pu‐Hung Lin, Hui‐Chen (Rita) Chang, Victoria Traynor, Wen‐Cheng Huang, Jed Montayre, Kee‐Hsin Chen
    Journal of Advanced Nursing.2021; 77(8): 3483.     CrossRef
  • A Note on Common Apathy versus Hypoactive Delirium in Critical Illness
    Jan N. M. Schieveld, Jacqueline J. M. H. Strik
    American Journal of Respiratory and Critical Care Medicine.2021; 203(7): 921.     CrossRef
  • Effect of Sedatives on In-hospital and Long-term Mortality of Critically Ill Patients Requiring Extended Mechanical Ventilation for ≥ 48 Hours
    Hannah Lee, Seongmi Choi, Eun Jin Jang, Juhee Lee, Dalho Kim, Seokha Yoo, Seung-Young Oh, Ho Geol Ryu
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Improving delirium detection in intensive care units: Multicomponent education and training program
    Liron Sinvani, Cynthia Delle Site, Tara Laumenede, Vidhi Patel, Suzanne Ardito, Anum Ilyas, Craig Hertz, Gisele Wolf‐Klein, Renee Pekmezaris, Negin Hajizadeh, Lily Thomas
    Journal of the American Geriatrics Society.2021; 69(11): 3249.     CrossRef
  • Delirium in Critical Illness Patients and the Potential Role of Thiamine Therapy in Prevention and Treatment: Findings from a Scoping Review with Implications for Evidence-Based Practice
    Sandra Lange, Wioletta Mędrzycka-Dąbrowska, Adriano Friganovic, Ber Oomen, Sabina Krupa
    International Journal of Environmental Research and Public Health.2021; 18(16): 8809.     CrossRef
  • The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting
    Dong Jung Kim, Bongyeon Sohn, Hakju Kim, Hyoung Woo Chang, Jae Hang Lee, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
    The Korean Journal of Thoracic and Cardiovascular Surgery.2020; 53(1): 8.     CrossRef
  • INCIDENCIA DE DELIRIO SEGÚN EL REGIMEN DE VISITAS EN UNA UNIDAD DE CUIDADOS INTENSIVOS
    Juan Carlos Muñoz Camargo
    Enfermería Intensiva.2020; 31(2): 94.     CrossRef
  • Incidence of delirium according to the visiting regime in an intensive care unit
    J.C. Muñoz Camargo
    Enfermería Intensiva (English ed.).2020; 31(2): 94.     CrossRef
  • The Diagnostic Accuracy of Critical Care Pain Observation Tool (CPOT) in ICU Patients: A Systematic Review and Meta-Analysis
    Yue Zhai, Shining Cai, Yuxia Zhang
    Journal of Pain and Symptom Management.2020; 60(4): 847.     CrossRef
  • Neurologic Manifestations of Systemic Disease: Sleep Disorders
    Eric M. Davis, Chintan Ramani, Mark Quigg
    Current Treatment Options in Neurology.2020;[Epub]     CrossRef
  • Delirium
    Melissa L.P. Mattison
    Annals of Internal Medicine.2020; 173(7): ITC49.     CrossRef
  • Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically Ill Mechanically Ventilated COVID-19 Patients
    Denise Battaglini, Gregorio Santori, Karthikka Chandraptham, Francesca Iannuzzi, Matilde Bastianello, Fabio Tarantino, Lorenzo Ball, Daniele Roberto Giacobbe, Antonio Vena, Matteo Bassetti, Matilde Inglese, Antonio Uccelli, Patricia Rieken Macedo Rocco, N
    Frontiers in Neurology.2020;[Epub]     CrossRef
Original Article
Neurology
The Effects of a Delirium Notification Program on the Clinical Outcomes of the Intensive Care Unit: A Preliminary Pilot Study
Jaesub Park, Seung-Taek Oh, Sunyoung Park, Won-Jung Choi, Cheung Soo Shin, Se Hee Na, Jae-Jin Kim, Jooyoung Oh, Jin Young Park
Acute Crit Care. 2018;33(1):23-33.   Published online February 6, 2018
DOI: https://doi.org/10.4266/acc.2017.00584
  • 9,047 View
  • 185 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Delirium is common among intensive care unit (ICU) patients, so recent clinical guidelines recommended routine delirium monitoring in the ICU. But, its effect on the patient’s clinical outcome is still controversial. In particular, the effect of systems that inform the primary physician of the results of monitoring is largely unknown.
Methods
The delirium notification program using bedside signs and electronic chart notifications was applied to the pre-existing delirium monitoring protocol. Every patient was routinely evaluated for delirium, pain, and anxiety using validated tools. Clinical outcomes, including duration of delirium, ICU stay, and mortality were reviewed and compared for 3 months before and after the program implementation.
Results
There was no significant difference between the two periods of delirium, ICU stay, and mortality. However, anxiety, an important prognostic factor in the ICU survivor’s mental health, was significantly reduced and pain tended to decrease.
Conclusions
Increasing the physician’s awareness of the patient’s mental state by using a notification program could reduce the anxiety of ICU patients even though it may not reduce delirium. The results suggested that the method of delivering the results of monitoring was also an important factor in the success of the delirium monitoring program.

Citations

Citations to this article as recorded by  
  • Adaptation and Validation of a Chart‐Based Delirium Detection Tool for the ICU (CHART‐DEL‐ICU)
    Karla D. Krewulak, Carmen Hiploylee, E. W. Ely, Henry T. Stelfox, Sharon K. Inouye, Kirsten M. Fiest
    Journal of the American Geriatrics Society.2021; 69(4): 1027.     CrossRef
Reviews
Policy
The ABCDEF Implementation Bundle
Annachiara Marra, Kwame Frimpong, E. Wesley Ely
Korean J Crit Care Med. 2016;31(3):181-193.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00682
  • 33,287 View
  • 1,410 Download
  • 4 Crossref
AbstractAbstract PDF
Long-term morbidity, long-term cognitive impairment and hospitalization-associated disability are common occurrence in the survivors of critical illness, with significant consequences for patients and for the caregivers. The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing ICU patient recovery and outcomes. The ABCDEF bundle includes: Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement. The purpose of this review is to describe the core features of the ABCDEF bundle.

Citations

Citations to this article as recorded by  
  • Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial
    Gülşen Kiliç, Sultan Kav
    Nursing in Critical Care.2023; 28(5): 698.     CrossRef
  • The impact of multidisciplinary huddle in decreasing time to extubation from mechanical ventilation
    Rana Al Tabee, AmalA Al Khalfan, KhaledA Al Awam
    Saudi Critical Care Journal.2020; 4(1): 15.     CrossRef
  • Patients´ experiences of pain in the intensive care – The delicate balance of control
    Mia Hylén, Eva Akerman, Ewa Idvall, Carin Alm‐Roijer
    Journal of Advanced Nursing.2020; 76(10): 2660.     CrossRef
  • Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview
    Dorota Ozga, Sabina Krupa, Paweł Witt, Wioletta Mędrzycka-Dąbrowska
    Healthcare.2020; 8(4): 578.     CrossRef
Psychology/Neurology
Intensive Care Unit Delirium
Yongsuk Kim, Sung Jin Hong
Korean J Crit Care Med. 2015;30(2):63-72.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.63
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AbstractAbstract PDF
Delirium is described as a manifestation of acute brain injury and recognized as one of the most common complications in intensive care unit (ICU) patients. Although the causes of delirium vary widely among patients, delirium increases the risk of longer ICU and hospital length of stay, death, cost of care, and post-ICU cognitive impairment. Prevention and early detection are therefore crucial. However, the clinical approach toward delirium is not sufficiently aggressive, despite the condition’s high incidence and prevalence in the ICU setting. While the underlying pathophysiology of delirium is not fully understood, many risk factors have been suggested. As a way to improve delirium-related clinical outcome, high-risk patients can be identified. A valid and reliable bedside screening tool is also needed to detect the symptoms of delirium early. Delirium is commonly treated with medications, and haloperidol and atypical antipsychotics are commonly used as standard treatment options for ICU patients although their efficacy and safety have not been established. The approaches for the treatment of delirium should focus on identifying the underlying causes and reducing modifiable risk factors to promote early mobilization.
Case Report
Severe Postoperative Delirium Lasting for Three Weeks: A Case Report
Jun Rho Yoon, Tae Kwan Kim, Su Jung Yoon, Yee Suk Kim, Si Hyun Kim, Man Gyu Kim, Jeong Ju Seo
Korean J Crit Care Med. 2004;19(1):42-46.
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  • 36 Download
AbstractAbstract PDF
Postoperative delirium in the intensive care unit is a serious problem that has recently attracted much attention. We present a 73-year-old female patient who was admitted by multiple fractures induced by an accident. We started general anesthesia for the operation of open reduction and internal fixation. After the discontinuation of general anesthesia, the patient was transported to the intensive care unit. The symptoms of delirium were developed and controlled with medications including haloperidols, benzodiazepines, and vitamins. The patient was recovered three weeks after the management and received two other operations, but delirium did not be developed again. She was discharged from the hospital without complications.

ACC : Acute and Critical Care