Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Righy, Cássia; Salluh, Jorge I.

doi:10.5935/0103-507x.20130027

Cited by 20 publications

(23 citation statements)

References 35 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Delirium increases the time of mechanical ventilation, hospital stay and patient mortality. Subsyndrome also appears in recent studies, with a significant association with the length of hospital stay in the ICU and hospital, causing greater patient dependence after discharge, however, without association with mortality, and not presenting itself as a marker of disease severity, but as a risk factor for patients (1,(3)(4)(5)(6) .…”

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Identification of delirium and subsyndromal delirium in intensive care patients

et al. 2019

View full text Add to dashboard Cite

Objective: identify delirium and subsyndromal delirium in intensive care patients; age, hospitalization time, and mortality. Method: a retrospective, quantitative study conducted in the Intensive Care Unit, using the Richmond Agitation-Sedation Scale to evaluate sedation and the Intensive Care Delirium Screening Checklist for the identification of delirium, with the participation of 157 patients. For statistical analysis, the t-test and the Chi-square test was carried out. Results: the majority presented subsyndromal delirium (49.7%). Mortality was 21.7%. The relationship between delirium and its subsyndromal with hospitalization time was statistically significant for both (p=0.035 and p <0.001), while age was significant only in the subsyndromal delirium (p=0.009). Conclusion: the majority of the patients presented subsyndromal delirium. The length of hospital stay was statistically significant in delirium and subsyndroma delirium. Age was significant only in subsyndromal delirium. The mortality of patients with delirium was higher than the others.

show abstract

Section: Introductionmentioning

confidence: 94%

“…Neurological pattern's alteration presented by patients in the Intensive Care Unit (ICU), commonly called psychosis is nowadays more understood, being called delirium and defined as a potentially reversible acute cerebral dysfunction that develops in a short period of time (hours or days) (1)(2)(3)(4) .…”

Section: Introductionmentioning

confidence: 99%

Identification of delirium and subsyndromal delirium in intensive care patients

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Entretanto, é rotina da UTI a interrupção diária da sedação, o que pode ter favorecido na redução do tempo de permanência se comparado com o previsto pelo APACHE IV. A maioria dos pacientes admitidos em UTIs é submetida a altas doses de sedativos, acarretando no aumento do tempo de internação, no prolongamento do uso do suporte ventilatório e no risco de óbito devido a outras possíveis complicações 13 .…”

Section: Análise Dos Dadosunclassified

Uso do escore APACHE IV como preditor de mortalidade e tempo de permanência em uma unidade de terapia intensiva

Carvalho¹,

Rezende²,

Reis³

et al. 2020

Rev Pesq Fisio

View full text Add to dashboard Cite

INTRODUÇÃO: A avaliação do risco de morte e o tempo estimado de permanência em Unidade de Terapia Intensiva (UTI) é uma prática clínica relevante para predizer a gravidade da doença e traçar estratégias eficazes para a melhora do paciente e dos indicadores de qualidade do hospital. OBJETIVO: Avaliar a confiabilidade do escore APACHE IV como preditor de mortalidade e tempo de permanência em uma UTI do sul do estado do Tocantins. MATERIAL E MÉTODO: Pesquisa de caráter descritivo e quali-quantitativo realizada nos prontuários dos pacientes internados em uma UTI do sul do estado do Tocantins.. Foram colhidas informações nos prontuários e aplicado o escore APACHE IV nos pacientes internados na UTI do sul do estado do Tocantins.no período de 24 de Outubro a 26 de Novembro de 2018. Foram excluídos os pacientes com período de internação inferior a 24 horas, que não realizaram todos os exames necessários para o APACHE IV, que foram transferidos do setor ou que não tiveram alta ou óbito ao final dessa pesquisa. Foi utilizado o coeficiente de correlação de Spearman para examinar a relação entre o escore APACHE-IV e o tempo de internação na UTI e para verificar a acurácia do APACHE-IV para mortalidade, à curva Receiver Operator Characteristic (ROC) com uma atribuição de 'bom'> 0,80. RESULTADOS: O escore APACHE IV foi aplicado em dez pacientes, sendo que este superestimou o período de permanência dos pacientes internados na UTI em estudo, com p<0,001 e a mortalidade geral, com diferença absoluta de 20% (p= 0,447). CONCLUSÃO: Baseada neste estudo, o APACHE IV não demonstrou confiabilidade para predição de mortalidade e tempo de permanência, porém a amostra insuficiente pode ter contribuído com esta conclusão.

show abstract

“…(14) However, the use of these strategies is still far from universal, (15) and it is unclear whether one of the two is more effective than the other.…”

Section: Introductionmentioning

confidence: 99%

Sedation protocols versus daily sedation interruption: a systematic review and meta-analysis

Nassar¹,

Park²

2016

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

ObjectiveThe aim of this study was to systematically review studies that compared a mild target sedation protocol with daily sedation interruption and to perform a meta-analysis with the data presented in these studies.MethodsWe searched Medline, Scopus and Web of Science databases to identify randomized clinical trials comparing sedation protocols with daily sedation interruption in critically ill patients requiring mechanical ventilation. The primary outcome was mortality in the intensive care unit.ResultsSeven studies were included, with a total of 892 patients. Mortality in the intensive care unit did not differ between the sedation protocol and daily sedation interruption groups (odds ratio [OR] = 0.81; 95% confidence interval [CI] 0.60 - 1.10; I2 = 0%). Hospital mortality, duration of mechanical ventilation, intensive care unit and hospital length of stay did not differ between the groups either. Sedation protocols were associated with an increase in the number of days free of mechanical ventilation (mean difference = 6.70 days; 95%CI 1.09 - 12.31 days; I2 = 87.2%) and a shorter duration of hospital length of stay (mean difference = -5.05 days, 95%CI -9.98 - -0.11 days; I2 = 69%). There were no differences in regard to accidental extubation, extubation failure and the occurrence of delirium.ConclusionSedation protocols and daily sedation interruption do not appear to differ in regard to the majority of analyzed outcomes. The only differences found were small and had a high degree of heterogeneity.

show abstract

Perceptions and practices regarding delirium, sedation and analgesia in critically ill patients: a narrative review

Cited by 20 publications

References 35 publications

Identification of delirium and subsyndromal delirium in intensive care patients

Identification of delirium and subsyndromal delirium in intensive care patients

Uso do escore APACHE IV como preditor de mortalidade e tempo de permanência em uma unidade de terapia intensiva

Sedation protocols versus daily sedation interruption: a systematic review and meta-analysis

Contact Info

Product

Resources

About