Delirium recognition and sedation practices in critically ill patients: A survey on the attitudes of 1015 Brazilian critical care physicians

Salluh, Jorge I.; Dal‐Pizzol, Felipe; Mello, Patrícia Machado Veiga de Carvalho; Friedman, Gilberto; Silva, Eliézer; Teles, José; Lobo, Suzana M.; Bozza, Fernando A.; Soares, Márcio

doi:10.1016/j.jcrc.2009.04.004

Cited by 83 publications

(94 citation statements)

References 25 publications

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“…Of the 234 patients, only 56 were assessed for delirium, with 12 (21%) of these screening positive. In a survey of 1015 Brazilian ICU physicians, 29 only 13% reported using a validated screening tool for delirium, and more than 90% cited "clinical evaluation" as a method of diagnosis. 29 However, 38% reported not screening for delirium whatsoever, while the remainder reported screening once or more per day.…”

Section: Discussionmentioning

confidence: 99%

“…In a survey of 1015 Brazilian ICU physicians, 29 only 13% reported using a validated screening tool for delirium, and more than 90% cited "clinical evaluation" as a method of diagnosis. 29 However, 38% reported not screening for delirium whatsoever, while the remainder reported screening once or more per day. When asked how delirium was managed, 88% of respondents said that haloperidol was used, and 45% and 36% used benzodiazepines and atypical antipsychotics, respectively (multiple answers were permitted).…”

Section: Discussionmentioning

confidence: 99%

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Antipsychotic Drug Use and Screening for Delirium in Mechanically Ventilated Patients in Canadian Intensive Care Units: An Observational Study

Thiboutot

Perreault

Rose

et al. 2016

CJHP

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antipsychotic Drug Use and Screening for Delirium in Mechanically Ventilated Patients in Canadian Intensive Care Units: An Observational Study

Thiboutot

Perreault

Rose

et al. 2016

CJHP

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“…Surveys of doctors highlight similar concerns. A survey of Brazilian critical care physicians found that less than 15% of respondents used validated delirium assessment tools [48]. An American survey of ICU clinicians found that despite the belief that the literature supported routine screening for delirium, only 40% of respondents did so, and of those, only a small number used specific delirium screening tools [49].…”

Section: Discussionmentioning

confidence: 99%

Delirium in Acute Stroke: A Survey of Screening and Diagnostic Practice in Scotland

et al. 2013

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Aims. To survey the use of delirium screening and diagnostic tools in patients with acute stroke across Scotland and to establish whether doctors and nurses felt the tools used were suitable for stroke patients. Methods. An invitation to participate in a webbased survey was e-mailed to 217 doctors and nurses working in acute stroke across Scotland. Descriptive statistics were used to report nominal data, and content analysis was used to interpret free text responses. Results. Sixty-five responses were logged (30% return rate). 48% of the respondents reported that they routinely screened newly admitted patients for delirium. Following initial screening, 38% reported that they screened for delirium as the need arises. 43% reported using clinical judgment to diagnose delirium, and 32% stated that they combined clinical judgment with a standardised tool. 28% of the clinicians reported that they used the Confusion Assessment Method; however, only 13.5% felt that it was suitable for stroke patients. Conclusions. Screening for delirium is inconsistent in Scottish stroke services, and there is uncertainty regarding the suitability of screening tools with stroke patients. As the importance of early identification of delirium on stroke outcomes is articulated in recent publications, validating a screening tool to detect delirium in acute stroke is recommended.

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“…The knowledge and the interest on delirium in critically ill patients have progressively increased over the course of the last few years. 33,35 Nonetheless, there is still a lack of homogeneity in the use of terminology especially by physicians and health-care personnel who do not specialise in neuropsychiatric disciplines and for different background training and categorisation system. In a previous international survey, 33 we found that two terms are very consistently used when referring to acute brain dysfunction in critically ill patients: 100% of the selected languages use the term 'coma' or 'koma' to describe patients unresponsive to verbal and/or physical stimuli, and 100% use delirium tremens to define delirium due to alcohol withdrawal.…”

Section: Delirium Terminologymentioning

confidence: 99%

Understanding terminology of delirium and long-term cognitive impairment in critically ill patients

Morandi

Pandharipande

Jackson

et al. 2012

Best Practice & Research Clinical Anaesthesiology

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Keywords: delirium long-term cognitive impairment terminology critical careDelirium, an acute brain dysfunction, frequently affects intensive care unit (ICU) patients during the course of a critical illness. Besides the acute morbidities, ICU survivors often experience longterm sequelae in the form of cognitive impairment (LTCI-CI). Though delirium and LTCI-CI are associated with adverse outcomes, little is known on the terminology used to define these acute and chronic co-morbidities. The use of a correct terminology is a key factor to spread the knowledge on clinical conditions. Therefore, we first review the epidemiology, definition of delirium and its related terminology. Second, we report on the epidemiology of LTCI-CI and compare its definition to other forms of cognitive impairments. In particular, we define mild cognitive impairment, dementia and finally postoperative cognitive dysfunction. Future research is needed to interpret the trajectories of LTCI-CI, to differentiate it from neurodegenerative diseases and to provide a formal disease classification.

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Delirium recognition and sedation practices in critically ill patients: A survey on the attitudes of 1015 Brazilian critical care physicians

Cited by 83 publications

References 25 publications

Antipsychotic Drug Use and Screening for Delirium in Mechanically Ventilated Patients in Canadian Intensive Care Units: An Observational Study

Antipsychotic Drug Use and Screening for Delirium in Mechanically Ventilated Patients in Canadian Intensive Care Units: An Observational Study

Delirium in Acute Stroke: A Survey of Screening and Diagnostic Practice in Scotland

Understanding terminology of delirium and long-term cognitive impairment in critically ill patients

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