Delirium

Setters, Belinda; Solberg, Laurence M.

doi:10.1016/j.pop.2017.04.010

Cited by 62 publications

(50 citation statements)

References 80 publications

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“…Elekrolit bozuklukları, dehidratasyon, üremi, hepatik disfonksiyon, kan şekeri dalgalanmaları, hipoksi, hiperkapni, enfeksiyonlar deliryumun diğer sık rastlanan sebepleridir. [7] Bu sebeple kan sayımı, elektrolitler, böbrek ve karaciğer fonksiyonları, akciğer grafisi (özellikle infeksiyon açısından), EKG (özellikle kardiyak iskemi, enfarktüs açısından), idrar tahlili (idrar yolu infeksiyonu açısından) yapılmalıdır. Etiyoloji bulunamazsa lomber ponksiyon, tiroid fonksiyonları, vitamin B12, folat düzeyleri, toksikoloji ve ilaç düzeyleri, EEG, nöro-görüntüleme gibi daha ileri testler yapılabilir.…”

Section: Discussionunclassified

“…6 Ayaktan polikliniğe başvuran hastalarda deliryum sıklığı az olmasına rağmen, yaşlı hasta nüfusunun artması ve deliryumun yüksek morbidite ve mortalitesi sebebiyle, birinci basamak hekimlerinin deliryumu tanıması ve gerekli yönlendirmeleri yapması gerekmektedir. 7 Evde sağlık hizmetleri demansı, nörolojik ve psikiyatrik tanıları olan, yatağa bağımlı olmasa bile, hem sağlık hem de sosyal açıdan evde sağlık hizmetini gerektiren durumdaki hastalarla sık karşılaşılan ve hekimin hastayı çevresi ve birlikte yaşadığı ailesiyle birlikte değerlendirme imkanı bulduğu klinik bir uygulamadır. Bu olguda "3 aydır yeme içmeyi reddetme, konuşmama ve uykusuzluk" yakınmaları nedeniyle yakınları tarafından evde sağlık hizmetlerine başvuruda bulunulan bir kadın hastanın aile hekimliği tarafından evinde değerlendirilmesi ve bu bağlamda multidisipliner hasta yönetimi anlatılmaktadır.…”

Section: Caseunclassified

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Psychomotor and cognitive evaluation in a home-care patient who refuses eating-drinking and speaking: A case report

Temiz¹,

Kani²

2017

tjtfp

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Section: Discussionunclassified

Section: Caseunclassified

Psychomotor and cognitive evaluation in a home-care patient who refuses eating-drinking and speaking: A case report

Temiz¹,

Kani²

2017

tjtfp

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“…Delirium is a common neuropsychiatric complication in an intensive care unit (ICU) with an incidence rate of 26%, and the prevalence of delirium in mechanically ventilated patients is as high as 80% (Sanchez-Hurtado et al, 2018;van den Boogaard, Schoonhoven, van der Hoeven, van Achterberg, & Pickkers, 2012;Setters & Solberg, 2017). Delirium is defined as resulting disturbances in attention, awareness, orientation, and cognition (Neufeld & Thomas, 2013) and often leads to adverse outcomes such as prolonged ICU admissions, persisting cognitive dysfunction, and increased mortality rate (Marcantonio, 2017;McCoy, 2018;Van Rompaey, Sabbe, Dilles, & Van den Boogaard, 2018).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis

Montgomery

Traynor

et al. 2020

Worldviews Ev Based Nurs

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Background Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment. Aim To evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients. Methods We searched five electronic databases including the Cochrane Library, PubMed, Embase, CINAHL, and a Chinese database for eligible diagnostic studies published in English or Mandarin up to December 2018. This diagnostic test accuracy meta‐analysis was limited to studies in intensive care unit (ICU) settings, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a standard reference to test the accuracy of delirium assessment tools. Eligible studies were critically appraised by two investigators independently. The summary of evidence was conducted for pooling and comparing diagnostic accuracy by a bivariate random effects meta‐analysis model. The pooled sensitivities and specificities, summary receiver operating characteristic curve (sROC), the area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated and plotted. The possibility of publication bias was assessed by Deeks’ funnel plot. Data Synthesis We identified and evaluated 23 and 8 articles focused on CAM‐ICU and ICDSC, respectively. The summary sensitivities of 0.85 and 0.87, and summary specificities of 0.95 and 0.91 were found for CAM‐ICU and ICDSC, respectively. The AUC of the CAM‐ICU was 0.96 (95% CI, 0.94–0.98), with DOR at 99 (95% CI, 55–177). The AUC of the ICDSC was 0.95 (95% CI, 0.92–0.96), and the DOR was 65 (95% CI, 27–153). Linking Evidence to Action CAM‐ICU demonstrated higher diagnostic test accuracy and is recommended as the optimal delirium assessment tool. However, the results should be interpreted with caution due to the between‐study heterogeneity of this diagnostic test accuracy meta‐analysis.

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“…Delirium is defined as a disturbance in mental abilities that results in severe confusion and reduced awareness of one's surroundings [ 6 ]. Although the mechanism is still largely unknown, ICU patients have been shown to be at a higher risk for developing delirium.…”

Section: Introductionmentioning

confidence: 99%

Providing Culturally Competent Care for COVID-19 Intensive Care Unit Delirium: A Case Report and Review

Lomiguen¹,

Rosete²,

Chin³

2020

Cureus

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Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. Caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, its high transmissibility required infected individuals to be placed in negative pressure isolation rooms when admitted to intensive care units (ICU). Studies have shown that limited social support can increase the risk of developing delirium during ICU stays. Minimal research exists on COVID-19-associated ICU delirium as hospitals and government organizations focus on combating equipment shortages and case surges. Here, we present the case of a 64-year-old Filipino male with COVID-19 ICU delirium status post-intubation and ventilation. His hospital course was complicated by the medical staff's assumption that the patient spoke Spanish and improved after being assigned a Tagalog-speaking nurse who facilitated family communication. This case highlights the importance of cultural competency and communication in the management of COVID-19 associated ICU delirium. In particular, Filipino cultural practices and their intersection with healthcare in the larger context of providing culturally competent care are highlighted. The use of culturally competent care serves to assure the use of appropriate services and reduces the occurrence of medical errors due to misunderstandings caused by differences in language or culture. Familial involvement is critical for ICU delirium; however, the COVID-19 pandemic has required healthcare providers to think beyond conventional means. The use of technology to virtually communicate with family also serves as a helpful tool to treat signs of delirium. As seen in this case, a lack of understanding of the Filipino culture resulted in assumptions on the part of the healthcare provider which led to the prolongation of delirium in a COVID-19 ICU patient, but the correct utilization of cultural competence helped the patient recover successfully.

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Delirium

Cited by 62 publications

References 80 publications

Psychomotor and cognitive evaluation in a home-care patient who refuses eating-drinking and speaking: A case report

Psychomotor and cognitive evaluation in a home-care patient who refuses eating-drinking and speaking: A case report

Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis

Providing Culturally Competent Care for COVID-19 Intensive Care Unit Delirium: A Case Report and Review

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