Sedoanalgesia and Delirium

Naik, Ramavath Devendra; Ely, E. W.; Elavarasi, Arunmozhimaran

doi:10.5005/jp/books/12700_10

Cited by 2 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hyperactive delirium confers a favorable prognosis compared to hypoactive delirium and is often easier to identify. [ 1 ]…”

Section: What Is Delirium?mentioning

confidence: 99%

“…Delirium is a condition characterized by an acute cognitive decline, a fluctuating mental status, disturbance of consciousness, inattention, or disorganized thinking. [ 1 ] It is a well-recognized adverse prognostic marker in Intensive Care Unit (ICU) patients and is associated with increased morbidity, mortality, and the development of long-term neurocognitive deficits. [ 2 3 ] The incidence has been reported to occur between 16% and 73%[ 4 5 6 7 8 ] of patients after cardiac surgery; yet, cardiac surgeons, anesthesiologists, intensivists, and nurses may fail to recognize delirium in up to 84% of patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Current approach to diagnosis and treatment of delirium after cardiac surgery

Evans¹,

Weiner²,

Arora³

et al. 2016

Ann Card Anaesth

View full text Add to dashboard Cite

Delirium after cardiac surgery remains a common occurrence that results in significant short- and long-term morbidity and mortality. It continues to be underdiagnosed given its complex presentation and multifactorial etiology; however, its prevalence is increasing given the aging cardiac surgical population. This review highlights the perioperative risk factors, tools to assist in diagnosing delirium, and current pharmacological and nonpharmacological therapy options.

show abstract

“…Hyperactive delirium confers a favorable prognosis compared to hypoactive delirium and is often easier to identify. [ 1 ]…”

Section: What Is Delirium?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current approach to diagnosis and treatment of delirium after cardiac surgery

Evans¹,

Weiner²,

Arora³

et al. 2016

Ann Card Anaesth

View full text Add to dashboard Cite

show abstract

“…Delirium is a disease characterized by acute cognitive decline, fluctuating mental status, consciousness impairment, lack of attention, or confusion (1). It is a recognized adverse prognostic marker in intensive care unit (ICU) patients, associated with increased incidence, mortality, and the development of long-term neurocognitive deficits (2).…”

Section: Introductionmentioning

confidence: 99%

Unveiling the nexus of postoperative fever and delirium in cardiac surgery: identifying predictors for enhanced patient care

Wang,

Shen,

Zhu

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundPostoperative delirium (POD) is a significant complication observed in cardiac surgery patients, characterized by acute cognitive decline, fluctuating mental status, consciousness impairment, and confusion. Despite its impact, POD often goes undiagnosed. Postoperative fever, a common occurrence after cardiac surgery, has not been comprehensively studied in relation to delirium. This study aims to identify perioperative period factors associated with POD in patients undergoing cardiopulmonary bypass, with the potential for implementing preventive interventions.MethodsIn a prospective observational study conducted between February 2023 and April 2023 at the Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, a total of 232 patients who underwent cardiac surgery were enrolled. POD assessment utilized the Confusion Assessment Method for the ICU (CAM-ICU), while high fever was defined as a bladder temperature exceeding 39°C. Statistical analysis included univariate and multivariate analyses, logistic regression, nomogram development, and internal validation.ResultThe overall incidence of postoperative delirium was found to be 12.1%. Multivariate analysis revealed that postoperative lactate levels [odds ratio (OR) = 1.787], maximum temperature (OR = 11.290), and cardiopulmonary bypass time (OR = 1.015) were independent predictors of POD. A predictive nomogram for POD was developed based on these three factors, demonstrating good discrimination and calibration. The prediction model exhibited a C-statistic value of 0.852 (95% CI, 0.763–0.941), demonstrating excellent discriminatory power. Sensitivity and specificity, based on the area under the receiver operating characteristic (AUROC) curve, were 91.2% and 67.9%, respectively.ConclusionThis study underscores the high prevalence of POD in cardiac surgery patients and identifies postoperative lactate levels, cardiopulmonary bypass duration, and postoperative fever as independent predictors of delirium. The association between postoperative fever and POD warrants further investigation. These findings have implications for implementing preventive strategies in high-risk patients, aiming to mitigate postoperative complications and improve patient outcomes.

show abstract

Sedoanalgesia and Delirium

Cited by 2 publications

References 0 publications

Current approach to diagnosis and treatment of delirium after cardiac surgery

Current approach to diagnosis and treatment of delirium after cardiac surgery

Unveiling the nexus of postoperative fever and delirium in cardiac surgery: identifying predictors for enhanced patient care

Contact Info

Product

Resources

About