Managing ICU delirium

Schiemann, Alexander; Hadzidiakos, Daniel; Spies, Claudia

doi:10.1097/mcc.0b013e32834400b5

Cited by 43 publications

(19 citation statements)

References 95 publications

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“…The CAM-ICU is particularly useful for the assessment of delirium in ICU patients undergoing artificial respiratory treatment. The CAM-ICU has been found to have a sensitivity of 95-100% compared to the application of DSM-IV criteria and has been described as valid tool with a specificity of 93-98% and a reliability of .79-.95 (Schiemann et al, 2011).…”

Section: Cam-icu Measurementmentioning

confidence: 99%

The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial

Moon

Lee

2015

International Journal of Nursing Studies

117

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Section: Cam-icu Measurementmentioning

confidence: 99%

The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial

Moon

Lee

2015

International Journal of Nursing Studies

117

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“…Correcting the acidosis alone was not enough to manage the delirium and the treatment was challenging. Delirium in patients treated in intensive care unit has been reported as a common and serious acute brain dysfunction with adverse outcome and high risk of mortality (1). Delirium is characterized by four features: 1) inattention and disturbance of consciousness, 2) change in cognition, 3) acute onset and fluctuating course, and 4) presence of a pathophysiological cause (2).…”

Section: Discussionmentioning

confidence: 99%

Delirium in Diabetic Ketoacidosis: A Case Report

Cebeci

Güven²

2012

jcrpe

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A 15-year-old female patient with known type 1 diabetes mellitus was referred because of abdominal pain. On admission, she was alert but dehydrated with marked Kussmaul breathing. Blood glucose was 414 mg/dL (23 mmol/L). Blood gas analysis revealed severe metabolic acidosis (pH: 6.99) with an elevated anion gap (29.8 mmol/L) and an increased base excess (-25.2 mmol/L). At the sixth hour of treatment with intravenous fluids and insulin, the patient became delirious. The delirium persisted despite the normalization of the acidosis and became difficult to manage. Brain imaging studies revealed neither brain edema nor other intracranial pathology. No evidence of intoxication could be found. The patient gradually regained consciousness and was diagnosed as a case of severe diabetic ketoacidosis (DKA) associated with infection. We were unable to find a similar case in the pediatric literature and thought that reporting this unusual case would be a contribution to the literature on DKA in children.Conflict of interest:None declared.

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“…ICU delirium has been referred to as ICU psychosis, acute brain dysfunction or failure, and acute encephalopathy, among other terms. ICU delirium can prolong mechanical ventilation and is associated with a threefold higher rate of re-intubation, an increased rate of ventilator-associated infections, prolonged hospital stays, and increased 1-year mortality [290,291]. Delirium is defined as a fluctuating change in attention, cognition, consciousness, and/or perception and can be further categorized as hyperactive, hypoactive, and mixed [290,292].…”

Section: Neurologic Adrsmentioning

confidence: 99%