Bright light and oxygen therapies decrease delirium risk in critically ill surgical patients by targeting sleep and acid-base disturbances

Potharajaroen, Sirimas; Tangwongchai, Sookjaroen; Tayjasanant, Thavatchai; Thawitsri, Thammasak; Anderson, Geoffrey M.; Maes, Michaël

doi:10.1016/j.psychres.2017.12.046

Cited by 38 publications

(52 citation statements)

References 40 publications

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“…During the full-text review of these 194 articles, 157 were excluded. In total 37 studies were included: 21 assessed association between environmental risk factors and delirium 13,19,20,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] , and 16 reported on delirium after an environmental intervention 7,14,15,18,[48][49][50][51][52][53][54][55][56][57][58][59] ( Figure 1).…”

Section: Literature Search Results and Outcomementioning

confidence: 99%

“…Included studies were conducted between 1997 to 2019, in the USA 19,31,37,39,43,46,58,59 , the Netherlands 14, 32,48,50,51 , Japan 38,41,52,53 , France 33,36,57 , Belgium 13,49 , Denmark 15,34 , Italy 42,47 , Sweden 18,20 , Canada 35 , China 45 , India 40 , Israel 30 , Singapore 55 , South Korea 54 , Thailand 56 , Turkey 44 , and the UK 7 . Of these, 31 studies were conducted among critically ill patients while five reviewed general hospital populations 30,35,41,44,54 , and one a geriatric monitoring unit for acute delirium care 55 .…”

Section: Characteristics Of the Reviewed Articlesmentioning

confidence: 99%

“…Most studies assessed delirium using the Confusion Assessment Method for the ICU (CAM-ICU) 7,15,18,19,34,36,37,39,40,42,[45][46][47][48]51,[56][57][58][59] ; other identification methods included the validated Dutch CAM-ICU 32 , Confusion Assessment Method (CAM) 41,50,55 , Intensive Care Delirium Screening Checklist (ICDSC) 14, 33,43 , Neelon and Champagne Confusion Scale (NEECHAM) 13,49 , non-validated 52 and validated 53 Japanese NEECHAM, Delirium Observation Screening Scale (DOSS) 50 , behavioral observations based on the Diagnostic and Statistical Manual of Mental Disorders, 3 rd edition (DSM-III) 35 , 3 rd edition-revised (DSM-III-R) 38 , and 4 th Edition (DSM-IV) 20,41,44 , and behavioral observations based on International Classification of Diseases, 9 th Revision, Clinical Modification (ICD-9-CM) criteria 30 . One study used both retrospective chart review and site-specific pre-specified criteria based on new and rapid onset of disturbed consciousness and/or perceptual disturbances 31 .…”

Section: Characteristics Of the Reviewed Articlesmentioning

confidence: 99%

“…In total, 16 studies evaluated the effects of a modified environment on delirium prevention or management 7,14,15,18,[48][49][50][51][52][53][54][55][56][57][58][59] ( Table 5-Table 7). Half were randomized control trials (RCT) 18,49,[51][52][53][54]56,57 , while half used different study designs including: before-after 7,14,48,59 , retrospective cohort 15,50 , and prospective cohort 55,58 . Sample sizes varied from 11 to 748.…”

Section: Effect Of Environmental Interventions On Delirium Preventionmentioning

confidence: 99%

“…Interventions focused on controlling environmental risk factors, including noise and light exposure, disrupted circadian rhythm, and sleep ( Figure 2). We categorized these interventions into four modification types: architectural design 18,48 , environmental noise 14, 49 , environmental light 15,[50][51][52][53][54][55][56][57] , and environmental modification bundles with noise and light components 7,[57][58][59] . A summary of environmental interventions on delirium and reported statistical results are presented in Table 8.…”

Section: Effect Of Environmental Interventions On Delirium Preventionmentioning

confidence: 99%

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The impact of environmental risk factors on delirium and benefits of noise and light modifications: a scoping review

et al. 2020

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Background: To explore existing literature on the association between environmental risk factors and delirium, and to investigate the effectiveness of environmental modifications on prevention or management of delirium. Methods: This is a scoping review of peer-reviewed studies in PubMed and the reference lists of reviewed articles. Observational studies reporting the effect of noise, light, and circadian rhythm on delirium and interventional studies assessing delirium in modified environments were reviewed. Results: 37 studies were included, 21 of which evaluated the impact of environment on delirium and 16 studied possible solutions to mitigate those impacts. Mixed findings of the reviewed studies yielded inconclusive results; a clearly delineated association between high noise levels, abnormal amounts of light exposure, and sleep disruption with delirium could not be established. The environmental interventions targeted reducing noise exposure, improving daytime and mitigating night-time light exposure to follow circadian rhythm, and promoting sleep. The overall evidence supporting effectiveness of environmental interventions was also of a low confidence; however, quiet-time protocols, earplugs, and bright light therapy showed a benefit for prevention or management of delirium. Conclusions: Environmental modifications are non-invasive, risk-free, and low-cost strategies that may be beneficial in preventing and managing delirium, especially when used as part of a multi-component plan. However, given the limited evidence-based conclusions, further high-quality and larger studies focusing on environmental modifications and delirium outcomes are strongly recommended.

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Section: Literature Search Results and Outcomementioning

confidence: 99%

Section: Characteristics Of the Reviewed Articlesmentioning

confidence: 99%

Section: Characteristics Of the Reviewed Articlesmentioning

confidence: 99%

Section: Effect Of Environmental Interventions On Delirium Preventionmentioning

confidence: 99%

Section: Effect Of Environmental Interventions On Delirium Preventionmentioning

confidence: 99%

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The impact of environmental risk factors on delirium and benefits of noise and light modifications: a scoping review

et al. 2020

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Egi

Ogura

Yatabe

et al. 2021

Acute Medicine & Surgery

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS], and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

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Symptoms in Advanced Hematologic Malignancies and Other Serious Hematologic Conditions

Davis,

Fernandez,

Vithalani

et al. 2023

Palliative Care in Hematologic Malignancies and Serious Blood Disorders

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Bright light and oxygen therapies decrease delirium risk in critically ill surgical patients by targeting sleep and acid-base disturbances

Cited by 38 publications

References 40 publications

The impact of environmental risk factors on delirium and benefits of noise and light modifications: a scoping review

The impact of environmental risk factors on delirium and benefits of noise and light modifications: a scoping review

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Symptoms in Advanced Hematologic Malignancies and Other Serious Hematologic Conditions

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