Delirium in Intensive Care

Poulsen, Lone Musaeus; Estrup, Stine; Mortensen, Camilla Bekker; Andersen-Ranberg, Nina Christine

doi:10.1007/s40140-021-00476-z

Cited by 28 publications

(15 citation statements)

References 73 publications

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“…16 A Danish version was used. 17 The FAS describes the participant's level of fatigue by 10 statements reflecting physical and mental fatigue. 18 Each question is answered with scores 1 to 5 indicating how often the statement occurs.…”

Section: Data Collectionmentioning

confidence: 99%

Long‐term cognitive and functional status in Danish ICU patients with COVID‐19

Weihe

Mortensen

Haase

et al. 2022

Acta Anaesthesiol Scand

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Background ICU admission due to COVID‐19 may result in cognitive and physical impairment. We investigated the long‐term cognitive and physical status of Danish ICU patients with COVID‐19. Methods We included all patients with COVID‐19 admitted to Danish ICUs between March 10 and May 19, 2020. Patients were the contacted prospectively at 6 and 12 months for follow‐up. Our primary outcomes were cognitive function and frailty at 6 and 12 months after ICU admission, estimated by the Mini Montreal Cognitive Assessment, and the Clinical Frailty Scale. Secondary outcomes were 6‐ and 12‐month mortality, health‐related quality of life (HRQoL) assessed by EQ‐5D‐5L, functional status (Barthel activities of daily living and Lawton–Brody instrumental activities of daily living), and fatigue (Fatigue Assessment Scale). The study had no information on pre‐ICU admission status for the participants. Results A total of 326 patients were included. The 6‐ and 12‐month mortality was 37% and 38%, respectively. Among the 204 six‐month survivors, 105 (51%) participated in the 6‐month follow‐up; among the 202 twelve‐month survivors, 95 (47%) participated in the 12‐month follow‐up. At 6 months, cognitive scores indicated impairment for 26% (95% confidence interval [CI], 11.4–12.4) and at 12 months for 17% (95% CI, 12.0–12.8) of participants. Frailty was indicated in 20% (95% CI, 3.4–3.9) at 6 months, and for 18% (95% CI, 3.3–3.8) at 12 months. Fatigue was reported by 52% at 6 months, and by 47% at 12 months. For HRQoL, moderate, severe, or extreme health problems were reported by 28% at 6 months, and by 25% at 12 months. Conclusion Long‐term cognitive, functional impairment was found in up to one in four of patients surviving intensive care for COVID‐19. Fatigue was present in nearly half the survivors at both 6 and 12 months. However, pre‐ICU admission status of the patients was unknown.

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Section: Data Collectionmentioning

confidence: 99%

Long‐term cognitive and functional status in Danish ICU patients with COVID‐19

Weihe

Mortensen

Haase

et al. 2022

Acta Anaesthesiol Scand

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“…Because delirium is a neurobehavioral syndrome caused by a transient disruption of normal neuronal activity mediated by alteration in neurotransmitter and neuronal network function [ 30 ], we chosen several neurotransmitter related DE mRNAs, and their co-expressed DE lncRNAs for validation of the RNA-sequencing results in EMP versus sham rats using qRT-PCR. In brief, total RNA was extracted from liquid nitrogen-frozen prefrontal cortex and hippocampus tissues.…”

Section: Methodsmentioning

confidence: 99%

Investigating the molecular mechanisms of delirium-like neuropsychiatric disorder induced by electromagnetic pulse based on bioinformatics analysis

Zhang

Xiao

et al. 2023

Mol Brain

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Electromagnetic pulse (EMP), a unique type of electromagnetic radiation, may induce diverse neuropsychiatric disorders, such as irritability, hyperkinesis, retardation of learning and memory. However, the underlying mechanism of EMP exposure on neuronal injury has not been elucidated. Here, we aimed to delineate the regulatory expression networks based on high-throughput sequencing data to explore the possible molecular mechanisms related to EMP-induced delirium-like neuropsychiatric disorder in rats. It’s shown that EMP exposure induced anxiety, cognitive decline and short-term memory impairment. The expression profiles of the long noncoding RNAs (lncRNAs) and mRNAs, along with their biological function and regulatory network, were explored in rats after EMP exposure. We identified 41 differentially expressed lncRNAs (DELs) and 266 differentially expressed mRNAs (DEMs) between EMP and sham groups. Sixty-one co-expression relationships between 18 DELs and 56 DEMs were mostly associated with synapse- and metabolic-related pathways. We predicted 51 DEL-miRNA pairs and 290 miRNA-mRNA pairs using the miRanda database to constructed a DEL-miRNA-DEM network. LncRNA AABR07042999.1 and mRNA Tph2, Slc6a4, Dbh and Th were upregulated, and the contents of serotonin, dopamine and norepinephrine were increased in both PFC and HIP after EMP exposure. The current study provided a better understanding of the ceRNA network, which might reveal the pathological mechanism and provide more treatment options for the EMP-induced neurobehavioral disorder.

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“…The mixed subtype is a fluctuation between the presentations of both the hyperactive and hypoactive states [9,10]. Hypoactive and mixed delirium are vastly more common than hyperactive delirium, although harder to diagnose and often overlooked [10].…”

Section: Delirium Definition Presentation and Incidencementioning

confidence: 99%

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Williams

Estime

Kuza

2023

Current Opinion in Anaesthesiology

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Purpose of reviewThis article reviews the impact and importance of delirium on patients admitted to the ICU after trauma, including the latest work on prevention and treatment of this condition. As the population ages, the incidence of geriatric trauma will continue to increase with a concomitant rise in the patient and healthcare costs of delirium in this population.Recent findingsRecent studies have further defined the risk factors for delirium in the trauma ICU patient population, as well as better demonstrated the poor outcomes associated with the diagnosis of delirium in these patients. Recent trials and meta-analysis offer some new evidence for the use of dexmedetomidine and quetiapine as preferred agents for prevention and treatment of delirium and add music interventions as a promising part of nonpharmacologic bundles.SummaryTrauma patients requiring admission to the ICU are at significant risk of developing delirium, an acute neuropsychiatric disorder associated with increased healthcare costs and worse outcomes including increased mortality. Ideal methods for prevention and treatment of delirium are not well established, especially in this population, but recent research helps to clarify optimal prevention and treatment strategies.

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Delirium in Intensive Care

Cited by 28 publications

References 73 publications

Long‐term cognitive and functional status in Danish ICU patients with COVID‐19

Long‐term cognitive and functional status in Danish ICU patients with COVID‐19

Investigating the molecular mechanisms of delirium-like neuropsychiatric disorder induced by electromagnetic pulse based on bioinformatics analysis

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

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