Delirium in intensive care unit patients under noninvasive ventilation: a multinational survey

Abstract

Objective To conduct a multinational survey of intensive care unit professionals to determine the practices on delirium assessment and management, in addition to their perceptions and attitudes toward the evaluation and impact of delirium in patients requiring noninvasive ventilation.Methods An electronic questionnaire was created to evaluate the profiles of the respondents and their related intensive care units, the systematic delirium assessment and management and the respondents' perceptions and attitudes regarding delirium in patients requiring noninvasive ventilation. The questionnaire was distributed to the cooperative network for research of the Associação de Medicina Intensiva Brasileira (AMIB-Net) mailing list and to researchers in different centers in Latin America and Europe.Results Four hundred thirty-six questionnaires were available for analysis; the majority of the questionnaires were from Brazil (61.9%), followed by Turkey (8.7%) and Italy (4.8%). Approximately 61% of the respondents reported no delirium assessment in the intensive care unit, and 31% evaluated delirium in patients under noninvasive ventilation. The Confusion Assessment Method for the intensive care unit was the most reported validated diagnostic tool (66.9%). Concerning the indication of noninvasive ventilation in patients already presenting with delirium, 16.3% of respondents never allow the use of noninvasive ventilation in this clinical context.Conclusion This survey provides data that strongly reemphasizes poor efforts toward delirium assessment and management in the intensive care unit setting, especially regarding patients requiring noninvasive ventilation.

Análise Do Perfil De Admissão, Evolução E Desfecho Intra-Hospitalar De Idosos: Coorte Prospectiva

“…A Confusion Assessment Method (CAM) é considerada o instrumento diagnóstico mais eficaz para auxiliar o diagnóstico de Delirium, sendo composto por quatro atributos: 1) Início agudo e curso flutuante; 2) Desatenção; 3) Pensamento Desorganizado; 4) Alteração do Nível de Consciência. O diagnóstico de Delirium é firmado quando se identifica a presença dos itens "1" e "2" e um dos itens de "3" ou "4" (TANAKA et al, 2015). O Identification of Seniors At Risk (ISAR) é um índice de predição de risco criado com o objetivo de detectar o aparecimento de comorbidades e desfechos adversos em idosos internados em emergências (GRONEWOLD et al, 2017).…”

Routine management of postoperative delirium outside the ICU: Results of an international survey among anaesthesiologists

“…Prior to the launch of the guideline, and following the “Appraisal of Guidelines for Research and Evaluation” instrument (AGREE II), the TF decided to monitor current practice in the detection, monitoring and treatment of POD by performing an international survey . Benchmarking implementation with surveys is not new: with respect to ICU delirium, experts, and geriatricians, there have been several surveys to evaluate the knowledge and current practice of clinicians . In 2014, one survey on a mono‐national level evaluated knowledge regarding neurocognitive complications among anaesthesiologists, and nurses specialised in anaesthesiology .…”

Assessment of delirium using the PRE-DELIRIC model in an intensive care unit in Argentina

“…( 3 , 6 - 9 ) In routine practice, healthcare staff typically do not diagnose delirium in patients who present with the condition. ( 3 , 10 - 12 ) However, the appropriate management of sedation and delirium can impact the outcome of ICU patients. ( 10 )…”