Pharmacological Management of Sleep–Wake Disturbances in Delirium DOI
Erik A. Levinsohn, Varsha Radhakrishnan,

Haley Euting

et al.

The Journal of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 16, 2024

Abstract Delirium is a heterogeneous syndrome primarily characterized by fluctuations in attention and awareness. Sleep–wake disturbances are common significant feature of delirium can manifest as circadian rhythm inversion, sleep fragmentation, reduced rapid eye movement (REM) slow‐wave sleep. Some literature suggests that the relationship between disruption reciprocal wherein two reinforce one another may share an underlying etiology. As there no FDA‐approved medications for or delirium‐related disturbances, management focused on addressing medical concerns promoting physiologic patterns with non‐pharmacological behavioral interventions. In practice, however, often used, albeit limited evidence to support their use. This review explores pharmacology pharmacokinetics several investigating use delirium: melatonin, ramelteon, dual orexin receptor antagonists (DORAs), dexmedetomidine. Current possible benefit ramelteon dexmedetomidine patients ICU setting, DORAs therapeutic options re‐regulation sleep–wake cycle delirium. We discuss pertinent pharmacokinetic pharmacodynamic factors influence clinical decision‐making regarding these

Language: Английский

Essential oils for clinical aromatherapy: A comprehensive review DOI Creative Commons
Lalitkumar K. Vora, Amol D. Gholap,

Navnath T. Hatvate

et al.

Journal of Ethnopharmacology, Journal Year: 2024, Volume and Issue: 330, P. 118180 - 118180

Published: April 16, 2024

Aromatherapy, a holistic healing practice utilizing the aromatic essences of plant-derived essential oils, has gained significant attention for its therapeutic potential in promoting overall well-being. Use phytoconstituent based oil played role evolving avenue aromatherapy as complementary system medicine.

Language: Английский

Citations

29
Guideline on positioning and early mobilisation in the critically ill by an expert panel DOI Creative Commons
Stefan J. Schaller, Flora T. Scheffenbichler, Thomas Bein

et al.

Intensive Care Medicine, Journal Year: 2024, Volume and Issue: 50(8), P. 1211 - 1227

Published: July 29, 2024

A scientific panel was created consisting of 23 interdisciplinary and interprofessional experts in intensive care medicine, physiotherapy, nursing care, surgery, rehabilitative pneumology delegated from societies together with a patient representative delegate the Association Scientific Medical Societies who advised methodological implementation. The guideline according to German (AWMF), based on Appraisal Guidelines for Research Evaluation (AGREE) II. topics (early) mobilisation, neuromuscular electrical stimulation, assist devices positioning, including prone were identified as areas be addressed assigned specialist expert groups, taking conflicts interest into account. formulated PICO questions (addressing population, intervention, comparison or control group well resulting outcomes), conducted systematic literature review abstract screening full-text analysis summary tables. This followed by grading evidence Oxford Centre Evidence-Based Medicine 2011 Levels Evidence risk bias assessment. recommendations finalized GRADE voted using an online Delphi process final hybrid consensus conference. long version approved professional associations. For this English update until April 2024 recommendation adapted new reviews randomized controlled trials. In total, 46 developed research gaps addressed.

Language: Английский

Citations

10
Unveiling the Immune Landscape of Delirium through Single‐Cell RNA Sequencing and Machine Learning: Towards Precision Diagnosis and Therapy DOI
Yan Shi,

Peipei Xu

Psychogeriatrics, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 1, 2025

Abstract Background Postoperative delirium (POD) poses significant clinical challenges regarding its diagnosis and treatment. Identifying biomarkers that can predict diagnose POD is crucial for improving patient outcomes. Methods To explore potential POD, we conducted bulk RNA sequencing (bulk‐seq) on peripheral blood samples from patients healthy controls. The expression levels of genes downstream the phosphatidylinositol 3‐kinase/protein kinase B (PI3K‐Akt) signalling pathway were analysed. We then validated these using quantitative real‐time polymerase chain reaction (RT‐qPCR) in an independent cohort 30 controls patients. Receiver operating characteristic (ROC) analysis six machine learning models used to evaluate predictive diagnostic value genes. Additionally, single‐cell (scRNA‐seq) was performed validate gene specific subsets mononuclear cells (PBMCs), including T‐cells, B‐cells, natural killer (NK) cells, dendritic (DCs), monocytes. Results Bulk‐seq revealed increased PI3K‐Akt pathway, specifically CHRM2 , IL6 NOS3 NGF IL6R compared Conversely, IGF1 significantly decreased. RT‐qPCR validation confirmed findings. ROC indicated are useful predicting diagnosing POD. scRNA‐seq further PBMC subsets, NK DCs, monocytes, with results consistent bulk‐seq data. Conclusions abnormal activation monocytes may serve as These findings could inform development novel therapeutic strategies managing

Language: Английский

Citations

1
Präventive Neurologie – nie zu früh und nie zu spät DOI

E. Schäffer,

Ulrike Schara‐Schmidt, Marlena Schnieder

et al.

DGNeurologie, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

Citations

1
Prophylactic Minocycline for Delirium in Critically Ill Patients DOI
Felipe Dal‐Pizzol, André Coelho, Carla Sasso Simon

et al.

CHEST Journal, Journal Year: 2023, Volume and Issue: 165(5), P. 1129 - 1138

Published: Dec. 1, 2023

Language: Английский

Citations

11
Propofol improves sleep deprivation‐induced sleep structural and cognitive deficits via upregulating the BMAL1 expression and suppressing microglial M1 polarization DOI Creative Commons
Huan Liu, Chenyi Yang, Xiaoqing Wang

et al.

CNS Neuroscience & Therapeutics, Journal Year: 2024, Volume and Issue: 30(7)

Published: July 1, 2024

Abstract Background Sleep deprivation (SD) is a growing global health problem with many deleterious effects, such as cognitive impairment. Microglia activation‐induced neuroinflammation may be an essential factor in this. Propofol has been shown to clear sleep debt after SD rats. This study aims evaluate the effects of propofol‐induced on ameliorating quality impairment and decline 48 h SD. Methods Almost 8–12‐week‐old rats were placed system for natural or continuous Afterwards, received propofol (20 mg·kg −1 ·h , 6 h) via tail slept naturally. The Morris water maze (MWM) Y‐maze test assessed spatial learning memory abilities. Rat EEG/EMG monitored sleep. expression brain muscle Arnt‐like protein 1 (BMAL1), brain‐derived neurotrophic (BDNF) hippocampus BMAL1 hypothalamus by western blot. Enzyme‐linked immunosorbent assay detected IL‐6, IL‐1β, arginase (Arg1), IL‐10 levels hippocampus. Immunofluorescence was used determine microglia well morphological changes. Results Compared control group, sleep‐deprived showed poor performance both MWM test, accompanied disturbances structure, including increased total time, time spent delta power non‐rapid eye movement In addition, induces abnormal circadian rhythm BMAL1, activates microglia, causes nerve damage. reversed these changes saved Furthermore, treatment significantly reduced hippocampal IL‐1β IL‐6 levels, BDNF, Arg1, switched surface markers from inflammatory M1 type anti‐inflammatory M2 type. Conclusion reduces SD‐induced disruption, possibly lowering neuronal inflammation switching phenotype activated state, thus exerting neuroprotective effects.

Language: Английский

Citations

4
The Impact of Relaxation Massage Prior to Bedtime on Sleep Quality and Quantity in People with Symptoms of Chronic Insomnia: A Home-Based Sleep Study DOI Open Access
Ilias Ntoumas, Christina Karatzaferi, Christoforos D. Giannaki

et al.

Healthcare, Journal Year: 2025, Volume and Issue: 13(2), P. 180 - 180

Published: Jan. 17, 2025

Background/Objectives: Manual massage is an effective treatment approach for reducing general stress and promoting overall sense of well-being. Relaxation aims to alleviate psychophysiological tension, enhance both blood lymphatic circulation, promote mental physical relaxation. It particularly beneficial those with anxiety-related symptoms (such as generalized anxiety disorder social anxiety) sleep disorders, aiming improve calmness sleepiness. Aims: The purpose the present study was assess effectiveness a single session relaxation prior bedtime on quality quantity indices in individuals chronic insomnia. Methods: In total, 20 (N = 20) healthy (aged 25.5 ± 12.0 years; 6F/14M) score Athens Insomnia Scale ≥16 participated under three different conditions over one week apart: (1) 45 min condition (REL), (2) sham (PLA), (3) control no massage. Sleep activity monitored using portable polysomnographic system. Results: A statistically significant effect observed between efficiency across sessions (p 0.034), notable (REL) 0.045). Additionally, sustained showed difference among 0.005). Conclusions: could be used safe non-pharmacological improving potentially restoring fragmented Trial registration number: trial registered at clinicaltrials.gov NCT06781866.

Language: Английский

Citations

0
Summary of the Best Evidence for Non‐Pharmacological Management of Sleep Disturbances in Intensive Care Unit Patients DOI

M Zhang,

Fei Yang, Chenwei Wang

et al.

Journal of Clinical Nursing, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 21, 2025

ABSTRACT Aim To retrieve, evaluate and summarise the best evidence for non‐pharmacological management of sleep disturbances in ICU patients, to provide basis clinical nursing practice. Design This study was an summary followed by reporting standard Fudan University Center Evidence‐based Nursing. Methods All on patients from both domestic international databases relevant websites systematically searched, including guidelines, expert consensuses, practice, decision‐making, summaries systematic review. Data Sources UpToDate, BMJ Best Practice, Joanna Briggs Institute, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Institute Health Clinical Excellence, Yi Maitong Registered Nurses Association Ontario, Canadian Medical Association: Practice Guideline, International WHO, Cochrane Library, CINAHL, Embase, PubMed, Web Science, CNKI, WanFang database, VIP SinoMed, The American Psychological Association, European Sleep Research Society, Academy Medicine Foundation were searched establishment June 1, 2024. Results A total 18 pieces literature included, involving 4 2 1 practice 11 reviews. 25 covering categories risk factors, monitoring, non‐pharmaceutical intervention, education training summarised. Conclusion summarises patients. In application, medical staff should make professional judgements fully combine situations patient preferences select evidence, laying a theoretical foundation later empirical research reduce incidence improve quality critically ill Implications Profession Patient Care can refer reasonable plans improving their life satisfaction. Impact has not received sufficient attention standardisation. Accurate standardised evaluation monitoring are help nurses enhance Reporting Method specifications Nursing, which based methodological process produced Institute. Nursing; registration number is ‘ES20231708’. or Public Contribution No Contribution.

Language: Английский

Citations

0
Perceptions and experiences of commercial virtual reality games in early postoperative rehabilitation among cardiac surgical patients: A qualitative study DOI Creative Commons

Zhongkang Wu,

Xihan Li, Lin Li

et al.

Digital Health, Journal Year: 2025, Volume and Issue: 11

Published: Jan. 1, 2025

Background Although numerous studies have focused on the outcomes of virtual reality games for early rehabilitation in postoperative cardiac surgical patients, research these patients’ perceptions and experiences with has been limited. Objectives The aim this qualitative study was to provide insights into surgery patients using commercial during rehabilitation. Methods A cohort ( n = 12) who used same VR period at intensive care unit (ICU) a tertiary hospital Nanjing, China, enrolled study, conducted between January 2023 December 2023. Data were collected through individual in-depth interviews analyzed Colaizzi's phenomenological method. Results Two themes emerged from interviews: (1) benefits rehabilitation, including (i) enhancing enthusiasm (ii) helping focus attention, (iii) increasing exercise, (iv) providing enjoyment, (v) regulating negative emotions; (2) shortcomings use games, producing stress, insufficient operating space, discomfort while wearing, difficulty mastering application, individualized needs. Conclusion Cardiac believed that beneficial but they highlighted some require improvement. results certain theoretical basis further promotion application clinical practice future.

Language: Английский

Citations

0
The effect of dexamethasone on the prevalence of delirium in older COVID-19 patients: a retrospective cohort study DOI
Chris van der Laan,

Kristel Goossens,

Sarah HM Robben

et al.

European Geriatric Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

Language: Английский

Citations

0