Mechanisms underlying delirium in patients with critical illness DOI Creative Commons
Yingying Fan,

Ruoyu Luo,

Meng-Tian Wang

et al.

Frontiers in Aging Neuroscience, Journal Year: 2024, Volume and Issue: 16

Published: Sept. 26, 2024

Delirium is an acute, global cognitive disorder syndrome, also known as acute brain characterized by disturbance of attention and awareness fluctuation symptoms. Its incidence high among critically ill patients. Once patients develop delirium, it increases the risk unplanned extubation, prolongs hospital stay, nosocomial infection, post-intensive care syndrome-cognitive impairment, even death. Therefore, great importance to understand how delirium occurs reduce in This paper reviews potential pathophysiological mechanisms patients, with aim better understanding its processes, guiding formulation effective prevention treatment strategies, providing a basis for clinical medication.

Language: Английский

The effect of nursing care provided to coronary intensive care patients according to their circadian rhythms on sleep quality, pain, anxiety, and delirium: a randomised controlled trial DOI Creative Commons
Meryem Pelin, Havva Sert

BMC Nursing, Journal Year: 2025, Volume and Issue: 24(1)

Published: Feb. 7, 2025

This study carried out to examine the effects of nursing care given coronary intensive patients according their circadian rhythms on sleep quality, pain, anxiety, and delirium. was designed as a randomised controlled, clinical investigation. The population consisted treated in unit training research hospital between September 2022 February 2023. Total 44 participants were included. included followed up for 3 days unit. Data collected using "Patient Information Form, Sleep Quality Scale Coronary Intensive Care Patients (SQ-CC), Visual Analogue (VAS), Morningness-Eveningness Questionnaire (MEQ), Hospital Anxiety Depression (HADS), Delirium Screening Checklist (ICDSC)." In addition, melatonin cortisol measurements made, data taken with smartwatch. intermediate chronotype, delirium, ventilator support, or sedative drugs excluded. chronotypes determined, intervention group by rhythms. No made control group, routine continued accordance functioning. Frequency distribution, dependent independent sample t-test, Wilcoxon test, repeated measures analysis variance, Mann Whitney U, chi-square used evaluate data. has been registered ClinicalTrials.gov (Identifiers: NCT04934436). During statistical analysis, groups coded Group A B, ensuring blinding statistician. group's quality increased compared (post-test SQ-CC total scores: 22.41 ± 6.67 vs. 50.45 10.63, p < 0.001). Although no significant difference found result study, there decrease pain score (VAS pre-test: 1.55 2.15, post-test: 0.68 2.21, = 0.036). anxiety decreased significantly HADS-Anxiety 3.18 3.29 8.50 5.66, post-test delirium higher ICDSC 0.32 0.48 1.18 0.50, Melatonin both without statistically differences them (melatonin levels: > 0.05). Considering sound levels environment, first-night decibel mean than (first-night mean: 56.58 2.43 dB 54.51 2.41 dB, Finally, smartwatch show times (p 0.05), but had more deep sleep, while less sleep. Nursing rhythm increases reduces risk acute syndrome

Language: Английский

Citations

2
Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement DOI
Melissa P. Knauert,

Najib T. Ayas,

Karen J. Bosma

et al.

American Journal of Respiratory and Critical Care Medicine, Journal Year: 2023, Volume and Issue: 207(7), P. e49 - e68

Published: March 31, 2023

Section:ChooseTop of pageAbstract <

Language: Английский

Citations

37
Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis DOI
Jiyeon Kang, Young Shin Cho, Minju Lee

et al.

Australian Critical Care, Journal Year: 2022, Volume and Issue: 36(4), P. 640 - 649

Published: June 17, 2022

Language: Английский

Citations

38
Sleep assessment in critically ill adults: A systematic review and meta-analysis DOI
Ellaha Kakar,

Matthijs Priester,

Pascale Wessels

et al.

Journal of Critical Care, Journal Year: 2022, Volume and Issue: 71, P. 154102 - 154102

Published: July 15, 2022

Language: Английский

Citations

21
E4BP4 Coordinates Circadian Control of Cognition in Delirium DOI
Min Chen, Li Zhang,

Mingting Shao

et al.

Advanced Science, Journal Year: 2022, Volume and Issue: 9(23)

Published: June 17, 2022

Abstract Improved understanding of the etiologies delirium, a common and severe neuropsychiatric syndrome, would facilitate disease prevention treatment. Here, authors invesitgate role circadian rhythms in pathogenesis delirium. They observe perturbance mouse models delirium disrupted clock gene expression patients with In turn, physiological genetic disruptions sensitize mice to aggravated cognitive impairment. Likewise, global deletion E4bp4 (E4 promoter‐binding protein), markedly altered conditions, results exacerbated delirium‐associated decline. Cognitive decline is attributed microglial activation impaired long‐term potentiation hippocampus. Single‐cell RNA‐sequencing reveals microglia as regulatory target . restrains via inhibiting ERK1/2 signaling pathway. Supporting this, lacking are delirious prone, whereas specifically deleted hippocampal CA1 neurons have normal phenotype. Mechanistically, inhibits by trans‐repressing Mapk1/3 (genes encoding ERK1/2) direct binding D‐box element promoter region. These findings define causal dysfunction development indicate regulator cognition at crosstalk between

Language: Английский

Citations

20
Delirium management and current practice among Intensive Care Units Doctors, Khartoum DOI Creative Commons

Sheema Hamid Seidna Hamid,

Ghada Omer Hamad Abd El‐Raheem,

Hana Eltayeb Salih Elamin

et al.

F1000Research, Journal Year: 2025, Volume and Issue: 13, P. 456 - 456

Published: Feb. 19, 2025

Delirium is a brain dysfunction characterized by attention and cognitive disturbances in fluctuating manner. The international guidelines recommend daily screening for delirium. Confusion Assessment Method the Intensive Care Unit (CAM-ICU) Delirium Screening Checklist (ICDSC) are most commonly used methods assessing This study aimed to identify barriers gaps knowledge practice. was hospital-based Cross-Sectional study. Stratified random sampling this 72 ICU doctors were randomly selected. Statistical analyses performed using IBM SPSS version 23. Descriptive data presented, chi-squared test determine associations among variables. significance set at p < 0.05. More than 70% of ≤ 30 years age female. A total 69.4% participants had 1year experience. In total, 94.4% worked medical ICUs. Less 20% delirium assessment tools, with statistically significant difference based on experience (p=0.012). not regularly assessed 13.9% patients. Non-pharmacological management applied 76.4% doctors, communication patients frequent (75%). Haloperidol drug (83.3%). 40.3% did stop medication discharge. regular performed. However, use validated tools uncommon. Nonpharmacological important mostly Our prescribed antipsychotics treatment both forms delirium, almost half them medications Medication reconciliation contact next in-charge important.

Language: Английский

Citations

0
Lipid Dysregulation and Delirium in Older Adults: A Review of the Current Evidence and Future Directions DOI Creative Commons

AnaLee Shaw,

Rujia Teng,

Toluwani Fasina

et al.

Brain Research Bulletin, Journal Year: 2025, Volume and Issue: 224, P. 111299 - 111299

Published: March 12, 2025

Delirium is a complex medical condition marked by acute episodes of cognitive dysfunction and behavioral disturbances, with multifaceted etiology challenging management across various clinical settings. Older adults, particularly in postoperative contexts, are at increased risk developing delirium. Despite extensive research, single underlying pathophysiological mechanism for delirium remains elusive. However, emerging evidence suggests correlation between lipid dysregulation development elderly patients, especially This connection has led to proposed treatments targeting dyslipidemia associated neuroinflammatory effects acute-phase review aims synthesize current literature on the relationship older highlighting need further research into specific neurolipidome constituents age-related profile changes, potentially uncovering novel therapeutic strategies

Language: Английский

Citations

0
The Impact of Dynamic Lighting on Sleep Timing and Duration for Hospitalised Patients DOI Open Access
Andrew Dunn,

Barbara Rabin Fastman,

Alan Weinberg

et al.

Journal of Sleep Research, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

ABSTRACT Poor sleep is common in hospitalised patients due to multiple factors, including disruption of the circadian rhythm. Few studies have examined programmable artificial lighting systems hospital patient rooms, and few achieved meaningful improvement sleep. We sought determine how novel dynamic affects timing duration compared standard lighting. Patients were admitted rooms on a cardiology unit with customised intervention or The system delivered blue‐enriched light during day, melanopic stimulus twice daily blue‐depleted evening. Sleep/wake probability was measured 30‐s epochs using mattress sensors capture nocturnal duration. Subjective alertness assessed diaries Karolinska Sleepiness Scale (KSS), respectively. A total 87 enrolled. Subjects experiencing demonstrated significantly advanced rest/wake activity phase by 160 min overall greater probability. Overnight (11 p.m.–7 a.m.) 66 condition (266 vs. 200 min, p < 0.05). group reported higher levels morning (KSS score 3.8 4.9, = 0.01) evening (5.4 7.1, 0.01). programmed entrain rhythm provide daytime associated phase, increased perceived alertness. These results suggest that potential improve for patients.

Language: Английский

Citations

0
The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial DOI

Seyed Afshin Shorofi,

Pooneh Dadashian,

Paul Arbon

et al.

Australian Critical Care, Journal Year: 2023, Volume and Issue: 37(1), P. 74 - 83

Published: Oct. 4, 2023

Language: Английский

Citations

8
Circadian rhythm disturbance and delirium in ICU patients: a prospective cohort study DOI Creative Commons
Jingjing Li, Shining Cai, Xiao Liu

et al.

BMC Anesthesiology, Journal Year: 2023, Volume and Issue: 23(1)

Published: June 13, 2023

Abstract Background Patients treated in the intensive care unit (ICU) may experience a reversal of day and night. The circadian rhythm ICU patients can be disturbed. Methods To explore relationship between delirium rhythms melatonin, cortisol sleep. A prospective cohort study was carried out surgical tertiary teaching hospital. who were conscious during stay after surgery scheduled to for more than 24 h enrolled. Serum melatonin plasma levels measured three times by drawing arterial blood on first days admission. Daily sleep quality assessed Richard-Campbell Sleep Questionnaire (RCSQ). Confusion Assessment Method Intensive Care Unit (CAM-ICU) performed twice screen delirium. Results total 76 included this study, 17 developed their stay. Melatonin different at 8:00 ( p = 0.048) 1, 3:00 0.002) 0.009) 2, all time points 3 0.032, 0.014, 0.047) non-delirium patients. level significantly lower that 16:00 1 0.025). changes secretion exhibited obvious biological rhythmicity < 0.001 0.026 cortisol), while no found group 0.064 0.454 cortisol). There significant difference RCSQ scores two groups. Conclusions disturbance associated with development Clinical staff should pay attention importance maintaining patients’ normal ICU. Trial registration registered US National Institutes Health ClinicalTrials.gov(NCT05342987) (25/04/2022).

Language: Английский

Citations

7