Prevalence of Delirium with Dexmedetomidine Compared with Morphine Based Therapy after Cardiac Surgery

Shehabi, Yahya; Grant, Peter; Wolfenden, Hugh; Hammond, Naomi; Bass, Frances; Campbell, Michelle; Chen, Jack

doi:10.1097/aln.0b013e3181b6a783

Cited by 286 publications

(295 citation statements)

References 40 publications

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“…The DEXCOM (Dexmedetomidine Compared to Morphine) study randomized such patients to dexmedetomidine or morphine and showed that dexmedetomidine reduced the duration but not incidence of delirium 63. Djaiani et al randomized patients to dexmedetomidine versus propofol and found that dexmedetomidine reduced the incidence of delirium (17.5% versus 31.5%, OR 0.46; P =0.028) and reduced duration (2 days versus 3 days, P =0.04) 64.…”

Section: Preventionmentioning

confidence: 99%

Delirium in the Cardiac Intensive Care Unit

Khalil

McCarthy

et al. 2018

JAHA

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Section: Preventionmentioning

confidence: 99%

Delirium in the Cardiac Intensive Care Unit

Khalil

McCarthy

et al. 2018

JAHA

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“…Similar findings were referred to in a metaanalysis by Lynn and others [39] analysing the safety and efficiency of dexmedetomidine with post-operative cardio-surgical patients. Numerous studies comparing dexmedetomidine to propofol [40,41], midazolam [40,42,43], and morphine [44] confirmed that dexmedetomidine reduces the risk of delirium, agitation and/or confusion in critical ICU patients. This medicine is not yet registered in Serbia.…”

Section: Discussionmentioning

confidence: 99%

The importance of early recognition and timely treatment of delirium in intensive care units

Stašević-Karličić¹,

Stasevic²,

Djordjević³

et al. 2016

Praxis Med

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Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days) and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia). The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A -Delirium as a sign of system infection, B -Therapy -Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C -An inconspicuous onset of delirium is overlooked, D -Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F -Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H -The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30-40% of cases (50). An etiological treatment would help avoid complicating delirium's clinical picture and would very much prevent poor outcomes, such as institutionalisation, cognitive damage and delirious patients' high mortality rate.

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“…A promising therapy that can not only treat delirium symptoms but may also prevent the development of delirium is the alpha-2 agonist dexmedetomidine. Several studies have shown that dexmedetomidine, when used for sedation of patients on mechanical ventilation, can reduce the incidence and duration of delirium (8)(9)(10)(11) and hasten extubation of patients with hyperactive delirium (12,13). There is little data, however, on its effectiveness in non-intubated patients.…”

mentioning

confidence: 94%

Dexmedetomidine for the treatment of hyperactive delirium refractory to haloperidol in non-intubated patients

2016

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Prevalence of Delirium with Dexmedetomidine Compared with Morphine Based Therapy after Cardiac Surgery

Abstract: Dexmedetomidine reduced the duration but not the incidence of delirium after cardiac surgery with effective analgesia/sedation, less hypotension, less vasopressor requirement, and more bradycardia versus morphine regimen.

Cited by 286 publications

References 40 publications

Delirium in the Cardiac Intensive Care Unit

Delirium in the Cardiac Intensive Care Unit

The importance of early recognition and timely treatment of delirium in intensive care units

Dexmedetomidine for the treatment of hyperactive delirium refractory to haloperidol in non-intubated patients

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