Literature DB >> 19237884

Delirium and sedation in the intensive care unit: survey of behaviors and attitudes of 1384 healthcare professionals.

Rina P Patel1, Meredith Gambrell, Theodore Speroff, Theresa A Scott, Brenda T Pun, Joyce Okahashi, Cayce Strength, Pratik Pandharipande, Timothy D Girard, Hayley Burgess, Robert S Dittus, Gordon R Bernard, E Wesley Ely.   

Abstract

OBJECTIVE: A 2001 survey found that most healthcare professionals considered intensive care unit (ICU) delirium as a serious problem, but only 16% used a validated delirium screening tool. Our objective was to assess beliefs and practices regarding ICU delirium and sedation management. DESIGN AND
SETTING: Between October 2006 and May 2007, a survey was distributed to ICU practitioners in 41 North American hospitals, seven international critical care meetings and courses, and the American Thoracic Society e-mail database. STUDY PARTICIPANTS: A convenience sample of 1384 healthcare professionals including 970 physicians, 322 nurses, 23 respiratory care practitioners, 26 pharmacists, 18 nurse practitioners and physicians' assistants, and 25 others.
RESULTS: A majority [59% (766 of 1300)] estimated that more than one in four adult mechanically ventilated patients experience delirium. More than half [59% (774 of 1302)] screen for delirium, with 33% of those respondents (258 of 774) using a specific screening tool. A majority of respondents use a sedation protocol, but 29% (396 of 1355) still do not. A majority (76%, 990 of 1309) has a written policy on spontaneous awakening trials (SATs), but the minority of respondents (44%, 446 of 1019) practice spontaneous awakening trials on more than half of ICU days.
CONCLUSIONS: Delirium is considered a serious problem by a majority of healthcare professionals, and the percent of practitioners using a specific screening tool has increased since the last published survey data. Although most respondents have adopted specific sedation protocols and have an approved approach to stopping sedation daily, few report even modest compliance with daily cessation of sedation.

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Year:  2009        PMID: 19237884      PMCID: PMC3719180          DOI: 10.1097/CCM.0b013e31819b8608

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  73 in total

1.  Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study.

Authors:  T Rahkonen; R Luukkainen-Markkula; S Paanila; J Sivenius; R Sulkava
Journal:  J Neurol Neurosurg Psychiatry       Date:  2000-10       Impact factor: 10.154

2.  FDA warns antipsychotic drugs may be risky for elderly.

Authors:  Bridget M Kuehn
Journal:  JAMA       Date:  2005-05-25       Impact factor: 56.272

3.  Validating the diagnosis of delirium and evaluating its association with deterioration over a one-year period.

Authors:  I R Katz; K J Curyto; T TenHave; J Mossey; L Sands; M J Kallan
Journal:  Am J Geriatr Psychiatry       Date:  2001       Impact factor: 4.105

4.  Delirium in the intensive care unit: an under-recognized syndrome of organ dysfunction.

Authors:  E W Ely; M D Siegel; S K Inouye
Journal:  Semin Respir Crit Care Med       Date:  2001       Impact factor: 3.119

5.  Atypical neuroleptic malignant syndrome caused by olanzapine.

Authors:  J Nielsen; A M Bruhn
Journal:  Acta Psychiatr Scand       Date:  2005-09       Impact factor: 6.392

6.  High-dose intravenous haloperidol for agitated delirium following lung transplantation.

Authors:  J L Levenson
Journal:  Psychosomatics       Date:  1995 Jan-Feb       Impact factor: 2.386

7.  Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study.

Authors:  G L Zornberg; H Jick
Journal:  Lancet       Date:  2000-10-07       Impact factor: 79.321

8.  Use of a validated delirium assessment tool improves the ability of physicians to identify delirium in medical intensive care unit patients.

Authors:  John W Devlin; Jeffrey J Fong; Greg Schumaker; Heidi O'Connor; Robin Ruthazer; Erik Garpestad
Journal:  Crit Care Med       Date:  2007-12       Impact factor: 7.598

9.  Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial.

Authors:  Timothy D Girard; John P Kress; Barry D Fuchs; Jason W W Thomason; William D Schweickert; Brenda T Pun; Darren B Taichman; Jan G Dunn; Anne S Pohlman; Paul A Kinniry; James C Jackson; Angelo E Canonico; Richard W Light; Ayumi K Shintani; Jennifer L Thompson; Sharon M Gordon; Jesse B Hall; Robert S Dittus; Gordon R Bernard; E Wesley Ely
Journal:  Lancet       Date:  2008-01-12       Impact factor: 79.321

10.  Antipsychotic drug use and mortality in older adults with dementia.

Authors:  Sudeep S Gill; Susan E Bronskill; Sharon-Lise T Normand; Geoffrey M Anderson; Kathy Sykora; Kelvin Lam; Chaim M Bell; Philip E Lee; Hadas D Fischer; Nathan Herrmann; Jerry H Gurwitz; Paula A Rochon
Journal:  Ann Intern Med       Date:  2007-06-05       Impact factor: 25.391

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  77 in total

1.  Comparison and agreement between the Richmond Agitation-Sedation Scale and the Riker Sedation-Agitation Scale in evaluating patients' eligibility for delirium assessment in the ICU.

Authors:  Babar A Khan; Oscar Guzman; Noll L Campbell; Todd Walroth; Jason L Tricker; Siu L Hui; Anthony Perkins; Mohammed Zawahiri; John D Buckley; Mark O Farber; E Wesley Ely; Malaz A Boustani
Journal:  Chest       Date:  2012-07       Impact factor: 9.410

2.  Patterns of opiate, benzodiazepine, and antipsychotic drug dosing in older patients in a medical intensive care unit.

Authors:  Margaret A Pisani; Kyle Bramley; Michael T Vest; Kathleen M Akgün; Katy L B Araujo; Terrence E Murphy
Journal:  Am J Crit Care       Date:  2013-09       Impact factor: 2.228

Review 3.  Pharmacological and nonpharmacological management of delirium in critically ill patients.

Authors:  Dustin M Hipp; E Wesley Ely
Journal:  Neurotherapeutics       Date:  2012-01       Impact factor: 7.620

4.  Mental Status Documentation: Information Quality and Data Processes.

Authors:  Charlene Weir; Bryan Gibson; Teresa Taft; Stacey Slager; Lacey Lewis; Nancy Staggers
Journal:  AMIA Annu Symp Proc       Date:  2017-02-10

Review 5.  Acute hyperglycemia associated with short-term use of atypical antipsychotic medications.

Authors:  T Vivian Liao; Stephanie V Phan
Journal:  Drugs       Date:  2014-02       Impact factor: 9.546

6.  Delirium as a predictor of long-term cognitive impairment in survivors of critical illness.

Authors:  Timothy D Girard; James C Jackson; Pratik P Pandharipande; Brenda T Pun; Jennifer L Thompson; Ayumi K Shintani; Sharon M Gordon; Angelo E Canonico; Robert S Dittus; Gordon R Bernard; E Wesley Ely
Journal:  Crit Care Med       Date:  2010-07       Impact factor: 7.598

7.  Antipsychotic Drug Use and Screening for Delirium in Mechanically Ventilated Patients in Canadian Intensive Care Units: An Observational Study.

Authors:  Zoé Thiboutot; Marc M Perreault; David R Williamson; Louise Rose; Sangeeta Mehta; Melanie D Guenette; Deborah Cook; Lisa Burry
Journal:  Can J Hosp Pharm       Date:  2016-04-29

8.  Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers.

Authors:  Biren B Kamdar; Melissa P Knauert; Shirley F Jones; Elizabeth C Parsons; Sairam Parthasarathy; Margaret A Pisani
Journal:  Ann Am Thorac Soc       Date:  2016-08

9.  Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial.

Authors:  Valerie J Page; E Wesley Ely; Simon Gates; Xiao Bei Zhao; Timothy Alce; Ayumi Shintani; Jim Jackson; Gavin D Perkins; Daniel F McAuley
Journal:  Lancet Respir Med       Date:  2013-08-21       Impact factor: 30.700

10.  Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study.

Authors:  Russel J Roberts; Jeffrey F Barletta; Jeffrey J Fong; Greg Schumaker; Philip J Kuper; Stella Papadopoulos; Dinesh Yogaratnam; Elise Kendall; Renee Xamplas; Anthony T Gerlach; Paul M Szumita; Kevin E Anger; Paul A Arpino; Stacey A Voils; Philip Grgurich; Robin Ruthazer; John W Devlin
Journal:  Crit Care       Date:  2009-10-29       Impact factor: 9.097

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