View clinical trials related to Delirium.
Filter by:The purpose of this research is to study pre-operative sleep problems and delirium in Hispanic/Latino patients after heart and lung surgery.
Emerging evidence indicates that SARS-CoV-2, the etiologic agent of COVID-19, can cause neurological, neuropsychological and psychiatric complications. Given the global dimensions of the current pandemic, there is to consider the possible large-scale neurocognitive impact of COVID-19. Therefore, there is an urgent need for longitudinal studies to determine the acute and chronic effects that COVID-19 may have on the Central Nervous System. These putative effects include the possibility that the CNS serves as a reservoir for the virus, and that COVID-19 triggers CNS deleterious inflammatory cascades and neurodegenerative process. The public implications of these effects are very important in the long term.
There is limited data regarding sound levels and burden in the pediatric cardiac critical care unit and how this compares with WHO standards. We seek to record this data and correlate sound level with bolus sedation administration, patient delirium scores, and patient heart rate trends. Primary Outcomes - 1 peak sound level in cardiac ICU in decibels - 2 Mean sound level in cardiac ICU in decibels - 3 Compare sound levels to WHO recommendations Secondary Outcomes - 1 To explore patient and unit factors that might influence these levels - 2 To analyze sound levels in post-operative neonates, versus infants, versus children - 3 To analyze patients on invasive versus non-invasine versus no ventilation
Pediatric delirium (PD) is a poorly investigated clinical problem that needs to be further explored in a Danish context. Children are at risk of discomfort and suffering if they experience delirium. The condition is associated with prolonged mechanical ventilation, longer hospital stay, increased mortality, and risk of long-term cognitive impairment. Therefore, it is important to assess critically ill children with a validated tool to enable early detection and management of the condition. In this study, the investigators will determine the prevalence of pediatric intensive care delirium. To this end, the investigators will validate the Sophia Observation withdrawal Symptoms - Pediatric delirium scale (SOS-PD) for patient assessment.
Background: Physical restraint of patients in the intensive care unit (ICU) is a common practice, with estimated prevalence of 50% of all ICU patients, with and without invasive ventilation support(1). The prevalence of physical restraint varies between ICU's according to patient population (surgical, cardiac, trauma, burns and general intensive care patients). In mechanically ventilated patients, the physical restriction (tying the patient) is carried out frequently in addition to pharmacological treatment with analgesic and sedative medications, in order to prevent falling, self-inflicted injury or accidental removal of essential medical devices (tracheobronchial tubes, central venous infusions, drains, etc.) by the patient. In non-ventilated patients, physical restraint is often carried out in patients with delirium or cognitive decline, in addition to pharmacological anti -delirium therapy (1). However, physical restraint has many drawbacks, including injuries to the skin and the soft tissues, blood vessels, peripheral nerves, muscle and skeleton (2). In addition, physical restraint may exacerbate symptoms of restlessness and delirium and even increase the risk of developing post-traumatic stress disorder in these patients (3,4). Despite the high prevalence of physical restraint of ICU patients, with its disadvantages and advantages, currently there are no consensual criteria for physical restraint and the decision when and how long to use it is at the discretion of the attending physician. It is important to note that in recent years there has been a tendency to reduce the amount of sedation that mechanically ventilated patients are given, which may lead to an increase in the incidence of physical restraint of patients who are fully or partially conscious (5).
Immobilization in general internal medicine inpatients is a major contributor to morbidity and mortality. Goal-directed mobilization (GDM) may improve mobility. The aim of this study is to assess, if GDM increases physical activity (DEMMI score) during hospitalization and improves quality of care until 3 months after hospitalization.
Frail older persons with cognitive impairment are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with cognitive impairment and delirium.
Delirious patients often suffer from sleep disturbances such as insomnia, sleep fragmentation, daytime somnolence, and reversal of sleep-wake rhythms. There is evidence, that patients suffering from hyperactive, as well as hypoactive and mixed delirium suffer from disturbed circadian rhythm. The investigators hypothesize that the circadian melatonin profile in critically ill delirious patients measured at two-hourly intervals deviates significantly in terms of phase, width and amplitude from non-delirious critically ill patients with similar age and SOFA (Sequential Organ Failure Assessment) score.
Postoperative delirium (POD) is a common complication, and the incidence rate is about 25% in non cardiac surgery. Previous studies have reported that the total incidence of neurological pod ranged from 10% to 22%. Dexmedetomidine (DEX) is an a-2 adrenergic agonist for sedation. This kind of drug has little effect on respiratory function, is easy to wake up and has analgesic effect. It is a commonly used perioperative adjuvant drug. However, for neurosurgical patients with brain tumors, the role of DEX in POD is not clear. The purpose of this study was to investigate the effect of DEX on POD in neurosurgical brain tumor surgery.
Delirium is known to be one of the most common postoperative complications in elderly patients undergoing surgery. Because postoperative delirium can affect the length of hospital stay and prognosis significantly, it is important to identify the risk factors for postoperative delirium in advance. However, there have been few reports concerning intraoperative modifiable risk factors, such as postoperative pain, for postoperative delirium.