Post-ICU psychological morbidity in very long ICU stay patients with ARDS and delirium

Bashar, Farshid Rahimi; Vahedian‐Azimi, Amir; Hajiesmaeili, Mohammadreza; Salesi, Mahmood; Farzanegan, Behrooz; Shojaei, Seyedpouzhia; Goharani, Reza; Madani, Seyed Jalal; Moghaddam, Kivan G.; Hatamian, Sevak; Moghaddam, Hosseinali J.; Mosavinasab, Seyed M. M.; Elamin, Elamin M.; Miller, Andrew C.

doi:10.1016/j.jcrc.2017.08.034

Cited by 49 publications

(46 citation statements)

References 71 publications

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“…Smonig's findings differ from our observations. We have conducted a longitudinal cohort study of 16,000 ICU patients with acute respiratory distress syndrome (ARDS) on MV from 21 ICUs (10 mixed, 5 surgical, 6 medical) from 6 academic medical centers [2,3]. Here, we report the results of a retrospective secondary analysis of 4200 patients from the mixed medical-surgical ICUs of two academic hospitals to assess the impact of NL exposure on delirium incidence.…”

mentioning

confidence: 99%

Natural versus artificial light exposure on delirium incidence in ARDS patients

Vahedian‐Azimi

Bashar

Khan³

et al. 2020

Ann. Intensive Care

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confidence: 99%

Natural versus artificial light exposure on delirium incidence in ARDS patients

Vahedian‐Azimi

Bashar

Khan³

et al. 2020

Ann. Intensive Care

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“…Mechanical ventilatory assistance (2, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . 17…”

Section: Clinical Indicators For Icu Assistance Nmentioning

confidence: 99%

Cross mapping between clinical indicators for assistance in intensive care and nursing interventions

et al. 2020

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Objective: Identify the main clinical indicators for assistance in the Intensive Care Unit (ICU) and map them in the nursing interventions described by the Nursing Interventions Classification (NIC). Methods: Integrative literature review study, followed by cross-mapping between clinical indicators for assistance in the ICU care and NIC nursing interventions and activities. Results: 36 articles were identified, which resulted in 285 clinical indicators for ICU care, with mechanical ventilatory assistance, pain, sedation, psychomotor agitation, delirium, anxiety, altered heart rate, diet by naso tube / oroenteral and diarrhea the clinical indicators for assistance in the ICU the most prevalent. These were mapped in 12 Nursing Interventions Classification interventions and 130 nursing activities. Final considerations: It is concluded that the clinical indicators for ICU care associated with Nursing Interventions Classification are concrete data that assist intensive care nurses in their clinical practice.

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“…A prospective longitudinal cohort study was conducted of 16,000 ICU patients with ARDS on MV from 21 ICUs (10 mixed, 5 surgical, 6 medical) at 6 academic medical centers [20,21]. Herein is reported a retrospective secondary analysis of 4,200 patients from the mixed medical-surgical ICUs of two academic medical centers.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Herein is reported a retrospective secondary analysis of 4,200 patients from the mixed medical-surgical ICUs of two academic medical centers. The parent study wasapproved by the Investigative Review Board at Baqiyatallah University of Medical Sciences, Tehran, Iran (IR.BMSU.REC.1394.451) [20] and Shariati Hospital of Tehran University of Medical Sciences, Tehran, Iran. Written informed consent from the patient or designated surrogate was required for participation in the parent study.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…prevention, early diagnosis and treatment are important aspects of caring for the critically-ill patient [18,19]. The mechanism(s) of delirium remains unclear, and no diagnostic laboratory or imaging test is available [20,21]. The American Psychiatric Association's Diagnostic and Statistical Manual, 5th edition (DSM-V) de nes delirium by: disturbances of (1) attention, (2) cognition, (3) that develops over a short period, (4) differs from baseline, (5) uctuates, (5) is not otherwise explained by another neurocognitive disorder, and (6) with evidence suggesting a potential cause in the history, physical examination, or laboratory ndings [22].…”

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confidence: 99%

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Predictors of Delirium Incidence, Time to Onset, and Recurrence in a Mixed Medical-surgical ICU Population: A Secondary Analysis Using Cox and CHIAD Decision Tree Modeling

Moghadam

Miller

Rahimi–Bashar

et al. 2020

Preprint

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Background: To address whether in intensive care unit (ICU) patients, which factors correlate with development of delirium (primary outcome), as well as more rapid delirium onset and recurrence (secondary outcomes).Methods: A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors.Results: Increased delirium risk as associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95% CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95% CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95% CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with greater family engagement 0.092 (95% CI: 0.014-0.596, P=0.012), low staff burnout and anticipated turnover scores 0.093 (95% CI: 0.014-0.600, P=0.013), non-ICU length-of-stay (LOS)<15 days 0.725 (95% CI: 0.655-0.804, P<0.001), and ICU LOS ≤15 days 0.509 (95% CI: 0.456-0.567, P<0.001). CHAID modelling indicated that AL exposure and age <65 years conveyed a high risk of delirium incidence, whereas SOFA score ≤11, APACHE IV score >15 and natural light (NL) exposure were associated with moderate risk, and female sex were associated with low risk. More rapid time to delirium onset correlated with baseline sleep disturbance (P=0.049), high nursing care requirements (P=0.019), and prolonged ICU and non-ICU hospital LOS (P<0.001). Delirium recurrence correlated with age>65 years (HR 2.198; %95 CI: 1.101-4.388, P=0.026) and high nursing care requirements (HR 1.978, 95% CI: 1.096-3.569), with CHAID modeling identifying AL exposure (P<0.001) and age >65 years (P=0.032) as predictive variables.Conclusion: Development of ICU delirium correlated with application of physical restraints, high nursing care requirements, prolonged ICU and non-ICU LOS, exposure exclusively to AL (rather than natural), less family engagement, and greater staff burnout and anticipated turnover scores. ICU delirium occurred more rapidly in patients with baseline sleep disturbance, and recurrence correlated with presence of delirium on ICU admission, exclusive AL exposure, and high nursing care requirements.

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Post-ICU psychological morbidity in very long ICU stay patients with ARDS and delirium

Cited by 49 publications

References 71 publications

Natural versus artificial light exposure on delirium incidence in ARDS patients

Natural versus artificial light exposure on delirium incidence in ARDS patients

Cross mapping between clinical indicators for assistance in intensive care and nursing interventions

Predictors of Delirium Incidence, Time to Onset, and Recurrence in a Mixed Medical-surgical ICU Population: A Secondary Analysis Using Cox and CHIAD Decision Tree Modeling

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