Acute and Critical Care

Review Article

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

17,274 View
1,143 Download
30 Citations

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

Citations to this article as recorded by

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;[Epub] 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
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

Medical Residents' Perception and Emotional Stress on Withdrawing Life-Sustaining Therapy: Jae Young Moon, Hee Young Lee, Chae Man Lim, Younsuck Koh; Korean J Crit Care Med. 2012;27(1):16-23.; DOI: https://doi.org/10.4266/kjccm.2012.27.1.16

2,384 View
31 Download
4 Citations

Abstract PDF

BACKGROUND
In order to promote the dignity of terminal patients, and improve end-of-life care (EOL care) in Korea, consensus guidelines to the withdrawal of life-sustaining therapies (LST) were published in October, 2009. The aim of this study was to assess the current perception of the guideline among internal medicine residents and to identify barriers to the application of the guidelines.
METHODS
The study was designed prospectively on the basis of data from e-mail survey. We surveyed 98 medical residents working in 19 medical centers.
RESULTS
75.5% of respondents agreed with withdrawing (WD) of LST and 33.3% (33/98) of respondents were unaware of the guideline. Although 58.1% of all respondents had taken an EOL care class in medical school, about 30% of residents did feel uncomfortable with communicating with patients and surrogates. The most important obstacle for decision of WD of LST was the resident's psychological stress. 39.8% of medical residents felt guilty or failure after a patient's death, and 41.8% became often or always depressed in a patient's dying.
CONCLUSIONS
In order to protect and enhance the dignity and autonomy of terminal patients, the improvement of the medical training program in the hospitals and the more concern of educational leaders are urgent.

Citations

Citations to this article as recorded by

The Effects of South Korean Social Workers' Professional Resources on their Understanding of a Patient's Right to End-of-Life Care Decisions in Long-term Care Facilities
Sooyoun Han
Asian Social Work and Policy Review.2016; 10(2): 200. CrossRef
A Study of Social Workers’ Understanding of Elderly Patients’ and Family Caregivers’ Rights to End-of-Life Care Decisions and of Their Own Roles in the Process
Sooyoun Han
The Korean Journal of Hospice and Palliative Care.2015; 18(1): 42. CrossRef
The Current Status of Medical Decision-Making for Dying Patients in a Medical Intensive Care Unit: A Single-Center Study
Kyunghwa Shin, Jeong Ha Mok, Sang Hee Lee, Eun Jung Kim, Na Ri Seok, Sun Suk Ryu, Myoung Nam Ha, Kwangha Lee
Korean Journal of Critical Care Medicine.2014; 29(3): 160. CrossRef
The End-of-Life Care in the Intensive Care Unit
Jae Young Moon, Yong Sup Shin
Korean Journal of Critical Care Medicine.2013; 28(3): 163. CrossRef

First
Prev
Page of 1
Next
Last

Search