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

Morandi, Alessandro; Pandharipande, Pratik P.; Jackson, James C.; Bellelli, Giuseppe; Trabucchi, Marco; Ely, E. Wesley

doi:10.1016/j.bpa.2012.08.001

Cited by 35 publications

(21 citation statements)

References 73 publications

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“…ICU delirium is defined as an altered state of consciousness featuring disordered attention, impaired cognition, altered psychomotor activity (increased or decreased) and disorder of the sleep-wake cycle (Borthwick et al 2006, Tait 2016. It has an acute onset and is thought to be reversible (Borthwick et al 2006), although Morandi et al (2012) state that long-term cognitive impairment is common after diagnosis of ICU delirium. Delirium is associated with poorer outcomes, higher costs and increased mortality (Chevrolet and Jolliet 2007; The National Institute for Health and Care Excellence [NICE] 2010).…”

Section: Introductionmentioning

confidence: 99%

“…Incidence varies widely but it is thought to affect from 18% to 82% of critically ill patients (Ely et al 2004a;Morandi et al 2012). There are three subtypes: hyperactive, characterised by hallucinations and agitation; hypoactive, where the patient is withdrawn and inattentive; and mixed delirium, which fluctuates between the two (Elliott 2014).…”

Section: Introductionmentioning

confidence: 99%

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Critical care nurses' knowledge and practice of delirium assessment

Rowley-Conwy

2017

Br J Nurs

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Critical care nurses' knowledge and practice of delirium assessment

Rowley-Conwy

2017

Br J Nurs

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“…Long‐term cognitive impairment after critical illness is defined as the neuropsychological changes that tend to persist and cause deficits of a magnitude that impair daily function . The incidence of cognitive impairment after sepsis has been reported to range from 4% to 62% .…”

Section: Introductionmentioning

confidence: 99%

Long‐term patient‐important outcomes after septic shock: A protocol for 1‐year follow‐up of the CLASSIC trial

Kjær

Meyhoff

Madsen

et al. 2019

Acta Anaesthesiol Scand

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Background In patients with septic shock, mortality is high, and survivors experience long‐term physical, mental and social impairments. The ongoing Conservative vs Liberal Approach to fluid therapy of Septic Shock in Intensive Care (CLASSIC) trial assesses the benefits and harms of a restrictive vs standard‐care intravenous (IV) fluid therapy. The hypothesis is that IV fluid restriction improves patient‐important long‐term outcomes. Aim To assess the predefined patient‐important long‐term outcomes in patients randomised into the CLASSIC trial. Methods In this pre‐planned follow‐up study of the CLASSIC trial, we will assess all‐cause mortality, health‐related quality of life (HRQoL) and cognitive function 1 year after randomisation in the two intervention groups. The 1‐year mortality will be collected from electronic patient records or central national registries in most participating countries. We will contact survivors and assess EuroQol 5‐Dimension, ‐5‐Level (EQ‐5D‐5L) and EuroQol‐Visual Analogue Scale and Montreal Cognitive Assessment 5‐minute protocol score. We will analyse mortality by logistic regression and use general linear models to assess HRQoL and cognitive function. Discussion With this pre‐planned follow‐up study of the CLASSIC trial, we will provide patient‐important data on long‐term survival, HRQoL and cognitive function of restrictive vs standard‐care IV fluid therapy in patients with septic shock.

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“…This disorder usually manifests as a decline in memory, attention, language ability and/or social interaction 2,4,5 , and severe POCD can lead to changes in a patient's personality and social behavior 3,5,6 . Although the causes of POCD remain unclear, multiple diverse contributing factors have been suggested, including older age, which has been identified as an independent risk factor for developing POCD 3,7,8 .…”

Section: Introductionmentioning

confidence: 99%

Effects of vasodilator and esmolol-induced hemodynamic stability on early post-operative cognitive dysfunction in elderly patients: a randomized trial

Sun¹,

Yang²,

Sun³

et al. 2017

Afr H. Sci.

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Objective: To investigate the effect of continuous intravenous injection of nicardipine and/or nitroglycerin with or without esmolol on the occurrence of early post-operative cognitive dysfunction (POCD) in elderly patients. Methods: Elderly patients (n=340) who underwent radiofrequency ablation for atrial fibrillation were randomized into five groups: A, nicardipine; B nicardipine+esmolol; C, (nitroglycerin) group; D nitroglycerin+esmolol; E (control) groups. The hemodynamic parameters were recorded, and Mini Mental State Examination was used to assess cognitive function. Results: At 30 min and 60 minutes after anesthesia and at the conclusion of surgery, the rate pressure product value was significantly lower in Groups B (10621.1±321.7, 10544.2±321.8, and 10701.3±325.5, respectively) and D (10807.4±351.1, 10784.3±360.3, and 10771.7±345.7, respectively) than in Group E (13217.1±377.6, 13203.5±357.3, and 13119.2±379.5, respectively). The heart rate was significantly higher in Groups A (104.1±10.3, 104.9±11.1, and 103.9±11.8, respectively) and C (103.7±11.3, 105.5±10.5, and 107.7±11.7, respectively) than in Group E (89.3±12.0, 88.5±11.5, and 85.5±11.6, respectively). The incidence of POCD was significantly lower in Groups A and B than in Groups C, D, and E. Univariate regression analysis showed that regimens in Groups A, B, and E and doses of propofol and fentanyl were risk factors for POCD. Multivariate logistic regression analysis revealed significant associations between the incidence of POCD and interventions in Groups A and B. Conclusion: Maintenance of stable intraoperative hemodynamics using nicardipine and nitroglycerin or their combinations with esmolol, especially nicardipine with esmolol, reduced the incidence of POCD in the elderly with potential cardiovascular diseases. Afri Health Sci2016;16(4): 1056-1066

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

Cited by 35 publications

References 73 publications

Critical care nurses' knowledge and practice of delirium assessment

Critical care nurses' knowledge and practice of delirium assessment

Long‐term patient‐important outcomes after septic shock: A protocol for 1‐year follow‐up of the CLASSIC trial

Effects of vasodilator and esmolol-induced hemodynamic stability on early post-operative cognitive dysfunction in elderly patients: a randomized trial

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