Abstract:
PURPOSE OF REVIEW:Delirium is frequently encountered in the ICU and is associated with significant adverse outcomes. The increasingly recognized consequences of ICU delirium should enhance efforts to improve recognition and management of this serious problem. We aim to review the recent literature on ICU delirium, including risk factors, detection, management and long-term impact of disease. RECENT FINDINGS:We present the most recent evidence on risk factors for ICU delirium and its persistence. In addition, we aim to clarify some of the confusion surrounding the tools for detection and their limitation in practice. The literature reflects long-term neurocognitive impairments following ICU delirium and supports efforts to reduce these negative outcomes using protocol-driven sedation and ventilator management. Although haloperidol is widely accepted as the preferred pharmacologic treatment for delirium, its use is not seeded in robust evidence. Limited studies reflect the safety of atypical antipsychotics for treatment but lack clear improvement in delirium-related outcomes. We place an emphasis on the use of protocols to reduce the use of sedatives, particularly benzodiazepines in the management of ICU delirium. SUMMARY:Delirium remains an underrecognized and underdiagnosed problem. Detection tools are readily available and easy to use. Further understanding of risk factors is needed to identify most susceptible individuals and plan management, which should include prevention and therapy based on available evidence.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Jones SF,Pisani MAdoi
10.1097/MCC.0b013e32835132b9subject
Has Abstractpub_date
2012-04-01 00:00:00pages
146-51issue
2eissn
1070-5295issn
1531-7072journal_volume
18pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. RECENT FINDINGS:In 2003 to 2004, published experiences from Canada, the United States, and Europe indicate that the quality of life among out-of-hospital cardiac a...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000125494.84614.fb
更新日期:2004-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CR...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000377
更新日期:2017-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Modern technologies allow visualization of microcirculatory disorders. This review describes how the coagulatory inhibitors antithrombin and activated protein C (APC) can improve microcirculation in sepsis and transplantation. RECENT FINDINGS:The effects of antithrombin and APC on microcirculatory di...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000244121.54495.f7
更新日期:2006-10-01 00:00:00
abstract::Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient-ventilator interaction by matc...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200302000-00010
更新日期:2003-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute respiratory distress syndrome (ARDS) is a multifaceted lung disease with no current effective therapy. Many clinical trials using conventional pharmacologic therapies have failed, suggesting the need to examine alternative approaches. Thus, attention has focused on the therapeutic potential of c...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000061
更新日期:2014-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Since the 1980s, hypocaloric feeding has been regularly proposed in the critically ill, although there is no clear definition available, nor evidence-based strategy to support it. We aim to define hypocaloric feeding based on indirect calorimetric data and to discuss patient-relevant clinical outcomes...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3280895d47
更新日期:2007-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Treatment protocols targeting the rapid administration of appropriate antibiotics and hemodynamic support are now recognized as a key measure in the initial care of patients presenting with severe sepsis and septic shock. Strong evidence exists showing that time parameters, particularly in the emergen...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282e7d8e1
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Early detection of gastrointestinal motility disturbances is a major goal to reduce the incidence of this potentially disastrous event by prophylactic managements and early goal-directed therapy in patients at risk. RECENT FINDINGS:Gastroparesis frequently results in the inability to feed critically ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283356679
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Prerenal failure is used to designate a reversible form of acute renal dysfunction. However, the terminology encompasses several different conditions that vary considerably. The lack of a widely accepted definition for prerenal failure makes it impossible to determine the epidemiology, natural history...
journal_title:Current opinion in critical care
pub_type: 杂志文章
doi:10.1097/MCC.0b013e328332f6e3
更新日期:2009-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bef5
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current concepts in perioperative pulmonary management. RECENT FINDINGS:Preoperative risk assessment tools for perioperative pulmonary complications (POPCs) are evolving for both children and adults. Intraoperative management strategies have a demonstrable effect on outcomes. Lat...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bfc8
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Fluid removal and relief of congestion are central to treatment of acute heart failure. Diuretics have been the decongestive mainstay but their known limitations have led to the exploration of alternative strategies. This review compares diuretics with ultrafiltration and examines the recent evidence ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000134
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:We discuss the goals of resuscitation, in both the early and the later phases, measures of organ perfusion, fluid responsiveness and the consequences of tissue edema. RECENT FINDINGS:The cost of over-aggressive fluid resuscitation is increased organ failure and mortality. In anticipation of the upcom...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000116
更新日期:2014-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Traumatic injury continues to be a significant cause of morbidity and mortality in the year 2011. In addition, the healthcare expenditures and lost years of productivity represent significant economic cost to the affected individuals and their communities. Helicopters have been used to transport traum...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32834c5655
更新日期:2011-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute respiratory distress syndrome has been considered a morphologic and functional expression of lung injury caused by a variety of insults. Two distinct forms of acute respiratory distress syndrome/acute lung injury are described, because there are differences between pulmonary acute respiratory di...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200502000-00003
更新日期:2005-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Securing the airway to provide sufficient oxygenation and ventilation is of paramount importance in the management of all types of emergency patients. Particularly in severely injured patients, strategies should be adapted according to useful recent literature findings. RECENT FINDINGS:The role of ou...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000160
更新日期:2014-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews the results of case series and trials which evaluated venovenous extracorporeal membrane oxygenation (VV-ECMO) for severe respiratory failure. Potential indications of the technique in this setting are discussed. RECENT FINDINGS:Major technological improvements in extracorporeal ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328357f090
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Mortality/morbidity-based end points have been useful in evaluating treatments that modulate 'mediator variables' with a large effect size. Ventilation is usually a supportive measure, and hence is best seen as a 'moderator variable'. It can, therefore, have only a modest impact on disease-specific mo...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/mcc.0b013e32833548cf
更新日期:2010-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Esophageal manometry has shown its usefulness to estimate transpulmonary pressure, that is lung stress, and the intensity of spontaneous effort in patients with acute respiratory distress syndrome. However, clinical uptake of esophageal manometry in ICU is still low. Thus, the purpose of review is to ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000494
更新日期:2018-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Part II of this review gives an overview of the different maternal cardiac problems during pregnancy and their management, and developments over recent years. RECENT FINDINGS:Many studies published over the last 5 years provided new insights on different cardiac diseases in pregnancy. Publications di...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000179806.15328.b9
更新日期:2005-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The scope of this review is to describe what is known about injury outcomes and the principles by which they can be improved by acute phase interventions. Assessing which outcomes matter to trauma patients is important both for the evaluation of existing and novel acute interventions and to assess the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32834a9353
更新日期:2011-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this study is to review the recent literature describing how to assess and treat postcardiac arrest syndrome associated haemodynamics and manage oxygenation and ventilation derangements. RECENT FINDINGS:Postcardiac arrest syndrome is a well described entity that includes systemic ische...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000205
更新日期:2015-06-01 00:00:00
abstract:PURPOSE OF REVIEW:A significant number of patients hospitalized with heart failure are malnourished. Depletion of micronutrients, which is known to occur in heart failure for a variety of reasons, may contribute to myocardial abnormalities noted in heart failure. In this review, we focus on nutritional supplementation ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32833e10d4
更新日期:2010-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The following review intends to outline the unique aspects of providing cardiopulmonary resuscitation for the poisoned patient and highlights both current practice and new therapies that apply to toxicologic cases. RECENT FINDINGS:Although there are few prospective randomized studies to further evide...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32814b040c
更新日期:2007-06-01 00:00:00
abstract:PURPOSE OF REVIEW:There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. RECENT FINDINGS:Critical i...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000734
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The comparison of morbidity, mortality, and length-of-stay outcomes in patients receiving critical care requires adjustment based on their presenting illness. These adjustments are made with severity-of-illness models. These models must be periodically updated to reflect current medical practices. Thi...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283101643
更新日期:2008-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Severe acute respiratory syndrome (SARS) is a new disease that caused large outbreaks in several countries in the first half of 2003, resulting in infection in more than 8000 people and more than 900 deaths. During that time, a large body of literature rapidly emerged describing the clinical disease, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200402000-00009
更新日期:2004-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of the review is to summarize and discuss recent research regarding the role of mechanical ventilation in producing weakness and atrophy of the diaphragm in critically ill patients, an entity termed ventilator-induced diaphragmatic dysfunction (VIDD). RECENT FINDINGS:Severe weakness of th...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000272
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe current antimicrobial resistance in ESKAPE Gram-negative microorganisms and their situation in the ICUs, the implication of the so-called high-risk clones (HiRCs) involved in the spread of antimicrobial resistance as well as relevance of the COVID-19 pandemic in the potential increase of r...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000755
更新日期:2020-10-01 00:00:00
abstract:PURPOSE OF REVIEW:There is correlation between quality of bystander cardiopulmonary resuscitation and patient survival. Recent developments in defibrillator technology enable recording of cardiopulmonary resuscitation quality, and have shown quality of professional cardiopulmonary resuscitation far from guidelines' lev...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f827d3
更新日期:2008-06-01 00:00:00