Delirium

@article{Wilson2020Delirium,
  title={Delirium},
  author={Jo Ellen Wilson and Matthew F. Mart and Colm Cunningham and Yahya Shehabi and Timothy D. Girard and Alasdair M. J. MacLullich and Arjen J. C. Slooter and E. Wesley Ely},
  journal={Nature Reviews Disease Primers},
  year={2020},
  volume={6},
  pages={1-26}
}
Delirium, a syndrome characterized by an acute change in attention, awareness and cognition, is caused by a medical condition that cannot be better explained by a pre-existing neurocognitive disorder. Multiple predisposing factors (for example, pre-existing cognitive impairment) and precipitating factors (for example, urinary tract infection) for delirium have been described, with most patients having both types. Because multiple factors are implicated in the aetiology of delirium, there are… Expand
37 Citations

Figures and Tables from this paper

Incidence, Predictors and Outcomes of Delirium in Critically Ill Patients With COVID-19
TLDR
Delirium is common in critically ill patients with COVID-19 and appears to be associated with greater disease severity, when present, which is associated with worse functional status at discharge, but not increased mortality. Expand
Impaired Executive Function and Depression as Independent Risk Factors for Reported Delirium Symptoms: An Observational Cohort Study Over 8 Years
TLDR
Especially prior to elective surgery or medical interventions, screening for impaired executive function and depression could be helpful to identify patients who are at risk to develop delirium symptoms. Expand
Validation of the 4AT tool for delirium assessment in specialist palliative care settings: protocol of a prospective diagnostic test accuracy study
TLDR
The aim of the study is to determine the diagnostic accuracy of the 4AT for delirium detection against a reference standard, in hospice inpatients, to inform clinical practice regardingDelirium assessment in palliative care settings. Expand
Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis
TLDR
No studies on the association between psychotic features, visuospatial deficits or affective disturbances in delirium and outcomes, or studies reporting non-mortality outcomes are found, and it is recommended that future delIRium studies report outcomes by symptom domain. Expand
URMC-099 Prophylaxis Repairs Hippocampal Vascular Damage in an Orthopedic Model of Delirium Superimposed on Dementia
TLDR
It is found that URMC-099, the authors' brain-penetrant anti-inflammatory neuroprotective drug, prevented inflammatory endothelial activation, synapse loss, and microglial activation in their DSD model. Expand
Delirium and Associated Factors in a Cohort of Hospitalized Patients With Coronavirus Disease 2019
TLDR
Delirium is a common in-hospital complication of patients with CO VID-19 pneumonia, associated with disease severity; given the extensive number of active COVID-19 cases worldwide, it is essential to detect patients who are most likely to develop delirium during hospitalization. Expand
Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.
TLDR
Assessment of the effectiveness of single and multicomponent non-pharmacological interventions designed to prevent delirium in hospitalised patients outside intensive care units (ICU) showed that pooled data showed that multi-component non- PHARMaceutical interventions probably reduce the incidence of deliria compared to usual care. Expand
Cognitive Dysfunction After Analgesia and Sedation: Out of the Operating Room and Into the Pediatric Intensive Care Unit
TLDR
The interactive role of sedatives and the neurologic vulnerability of critically ill children as it pertains to survivorship and functional outcomes, which is the next frontier in pediatric intensive care is explored. Expand
Delirium in adult and paediatric ICU patients: what is the way forward?
TLDR
The theme of this issue of Nursing in Critical Care is delirium, and three groups have tried to identify the risk factors ofdelirium: Habeeb-Allah et al from Jordan, Gravante etal from Italy, Liang et alfrom Hong Kong, and several of these risk factors are identified as risk factors in PICU patients. Expand
The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity
TLDR
The 4AT seems to be a useful tool for delirium screening and may predict mortality, and the area under the receiver operating curve (AUC) had acceptable sensitivity and specificity when applied as a clinical routine. Expand
...
1
2
3
4
...

References

SHOWING 1-10 OF 466 REFERENCES
Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies
TLDR
It is hypothesized that published research on delirium and encephalopathy is highly segregated, and that this segregation would be linked to the clinical discipline of investigators. Expand
Unravelling the pathophysiology of delirium: a focus on the role of aberrant stress responses.
TLDR
This article proposes a basic classification for the etiological factors: direct brain insults and aberrant stress responses, and discusses in detail two stress response systems that are likely to be involved in the pathophysiology of delirium: inflammation and the sickness behavior response, and activity of the limbic-hypothalamic-pituitary-adrenal axis. Expand
The neuroinflammatory hypothesis of delirium
TLDR
The neuroinflammatory hypothesis of delirium is explored based on recent evidence derived from animal and human studies and shows compelling evidence that acute peripheral inflammatory stimulation induces activation of brain parenchymal cells, expression of proinflammatory cytokines and inflammatory mediators in the central nervous system. Expand
Antipsychotics for Treating Delirium in Hospitalized Adults
TLDR
A systematic review of randomized controlled trials (RCTs) and prospective observational studies to evaluate the benefits and harms of haloperidol and second-generation antipsychotic compared with placebo and with other antipsychotics for treating delirium in adult patients finds 5 outcomes that were identified, on a priori basis, as critical outcomes. Expand
Cholinesterase inhibitors for the treatment of delirium in non-ICU settings.
TLDR
There is insufficient evidence to support or refute the use of cholinesterase inhibitors for the treatment of delirium in non-ICU settings, and the quality of evidence is low due to the very small sample size. Expand
Antipsychotics for Preventing Delirium in Hospitalized Adults
TLDR
A prior systematic review examined the evidence for use of antipsychotics to prevent delirium in adult medical and surgical inpatients up to 2013 and determined that the evidence does not support the use of anti-psychotic medications for prevention or treatment ofDelirium. Expand
Delirium in elderly people
TLDR
In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention and no convincing evidence shows that pharmacological prevention or treatment is effective. Expand
Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis
TLDR
Lower structural connectivity strength and efficiency appear to characterize structural brain networks of patients at risk for delirium, possibly impairing the functional network, while functional network disintegration seems to be a final common pathway for the syndrome. Expand
Worsening Cognitive Impairment and Neurodegenerative Pathology Progressively Increase Risk for Delirium
  • D. Davis, D. Skelly, +11 authors C. Cunningham
  • Medicine, Psychology
  • The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
  • 2015
TLDR
A human population-based cohort with graded severity of existing Cognitive impairment and a mouse model with progressing neurodegeneration both indicate that the risk of delirium increases with greater severity of pre-existing cognitive impairment and neuropathology. Expand
Delirium in the intensive care unit: an under-recognized syndrome of organ dysfunction.
TLDR
The definition and salient features ofdelirium, its primary risk factors, a newly validated instrument for delirium assessment that is being developed for ICU nurses and physicians, and pharmacological agents associated with the development of deliria and used in its management are reviewed. Expand
...
1
2
3
4
5
...