“Burn Catatonia”

Quinn, Davin K.

doi:10.1097/bcr.0b013e31828c73c7

Cited by 9 publications

(2 citation statements)

References 39 publications

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“…Criterion D for “Catatonic Disorder Due to Another Medical Condition” (medical catatonia) disallows this diagnosis exclusively in the presence of delirium. Because of this, there is a virtual absence of data concerning the prevalence of catatonic signs in delirious patients and many believe that catatonia is under-recognized in the medically ill (1, 2, 20, 21). Some have even suggested that despite the DSM exclusionary criteria, delirium can co-exist with catatonic features in medical illness (22).…”

Section: Introductionmentioning

confidence: 99%

Delirium and Catatonia in Critically Ill Patients: The Delirium and Catatonia Prospective Cohort Investigation*

Wilson

Carlson

Duggan

et al. 2017

Critical Care Medicine

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Objective Catatonia, a condition characterized by motor, behavioral and emotional changes, can occur during critical illness and appear as clinically similar to delirium, yet its management differs from delirium. Traditional criteria for medical catatonia preclude it’s diagnosis in delirium. Our objective in this investigation was to understand the overlap and relationship between delirium and catatonia in ICU patients and determine diagnostic thresholds for catatonia. Setting Convenience cohort, nested within 2 ongoing randomized trials at a single institution. Patients We enrolled 136 critically ill patients on mechanical ventilation and/or vasopressors, randomized to two usual care sedation regimens. Measurements and Main Results Patients were assessed for delirium and catatonia by independent and masked personnel using Confusion Assessment Method for the ICU (CAM-ICU) and the Bush Francis Catatonia Rating Scale (BFCRS) mapped to DSM-5 criterion A for catatonia. Of 136 patients, 58 (43%) patients had only delirium, 4 (3%) had only catatonia, 42 (31%) had both and 32 (24%) had neither. In a logistic regression model, more catatonia signs were associated with greater odds of having delirium. For example, patient assessments with ≥3 DSM-5 symptoms (75th percentile) had, on average, 27.8 times the odds (IQR 12.7, 60.6) of having delirium compared with patient assessments with 0 DSM-5 criteria (25th percentile) present (p< 0.001). A cut-off of ≥4 Bush Francis Catatonia Screening Instrument (BFCSI) items was both sensitive (91%) 95% CI (82.9 – 95.3) and specific (91%) 95% CI (87.6 – 92.9) for DSM-5 catatonia. Conclusions Given that about 1 in 3 patients had both catatonia and delirium, these data prompt reconsideration of DSM-5 criteria for “Catatonic Disorder Due to Another Medical Condition” that preclude diagnosing catatonia in the presence of delirium.

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Section: Introductionmentioning

confidence: 99%

Delirium and Catatonia in Critically Ill Patients: The Delirium and Catatonia Prospective Cohort Investigation*

Wilson

Carlson

Duggan

et al. 2017

Critical Care Medicine

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“…Burn encephalopathy is a neurological injury caused by burns and can occur in up to 80% of burn and inhalation injury patients. [ 7 ] Notably, intracranial injury secondary to burn-related trauma or hypoxic brain injury may damage and delay recovery. Initial brain damage may be caused by hypoxia and the neurotoxicity of inhaling smoke.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Use of extracorporeal membrane oxygenation in children with burn injury: Case report and literature review

et al. 2023

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Rationale: Burns are one of the most debilitating injuries in the world and one of the major causes of accidental disability and death among children. Severe burns can result in irreversible brain damage, placing patients at high risk of brain failure and high mortality. Therefore, timely diagnosis and treatment of burn encephalopathy are crucial for improving prognosis. In recent years, extracorporeal membrane oxygenation (ECMO) has been increasingly used to improve the prognosis of patients with burns. Here, we report a case of ECMO treatment in a child with burns and review the relevant literature.Patient concerns: A 7-year-old boy with a modified Baux score of 24 presented with asphyxia, loss of consciousness, refractory hypoxemia, and malignant arrhythmia after smoke inhalation for 1 day. Fiberoptic bronchoscopy revealed a large amount of black carbon-like substances aspirated from the trachea.Diagnoses: Considering that the boy inhaled a large amount of smoke, the clinical manifestation was unclear consciousness, laboratory examination revealed continuous low blood oxygen saturation, and bronchoscopy revealed a large amount of black carbon-like substances in the trachea, thereby leading to the diagnosis of asphyxia, inhalation pneumonia, burn encephalopathy, multiple organ dysfunction syndrome, and malignant arrhythmia. In addition, pulmonary edema and carbon monoxide poisoning are caused by chemical agents, gas fumes, and vapors.Interventions: The boy's blood oxygen saturation and blood circulation remained unstable despite various ventilation methods and medications, thus we decided to use ECMO. After 8 days of ECMO support, the patient was successfully weaned from the machine.Outcomes: Under the application of ECMO, the respiratory and circulatory systems significantly improved. Nevertheless, due to the progressive brain injury caused by burns and the poor prognosis, the parents ceased all treatment and the boy passed away.Lessons: This case report demonstrates that brain edema and herniation can arise as phenotypes of burn encephalopathy, which is a challenge to treat in children. Children with confirmed or suspected burn encephalopathy should undergo diagnostic tests completed as soon as possible to confirm the diagnosis. After receiving ECMO treatment, the respiratory and circulatory systems of the burn victims reported significantly improved. Hence, ECMO is a viable alternative for supporting patients with burns.

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