Contributed by Ben Julian A. Palanca, MD, PhD, MSc, Associate Professor of Anesthesiology, Associate Professor of Psychiatry, Washington University School of Medicine in St. Louis; Affiliated Faculty, Department of Biomedical Engineering, Washington University; Director, Sleepy Brain Lab Predictive biomarkers for prognosticating delirium onset and severity are needed for targeting interventions that may prevent delirium onset. […]
Contributed by C. Adrian Austin, MD, MSCR, Divisions of Geriatric Medicine and Pulmonary Diseases and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC Anxiety, depression and ICU delirium may be linked.1 Approximately 10% of the U.S. population takes an antidepressant, most commonly a selective serotonin reuptake inhibitor (SSRI).2 It remains […]
Franchesca Arias, PhD Assistant Professor, Department of Clinical and Health Psychology, University of Florida By 2050 it is expected that over 22% of the global population will be >60 years old.1 Late adulthood is a unique life stage2 associated with distinct cognitive vulnerabilities and medical needs. Of those ≥ 65 years old in the United […]
Sara LaHue, MD Assistant Professor of Clinical Neurology, University of California, San Francisco We cannot improve upon what we do not measure. While data suggests that more than 7 million adults in the United States develop delirium each year, this is likely an underestimate as delirium is poorly recognized without systematic screening.1 Delirium itself is […]
Christina Boncyk, MD, MPH Assistant Professor of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN The generally positive results of older controlled studies evaluating antipsychotics for intensive care unit (ICU) delirium treatment helped potentiate the routine use of these agents in critically ill adults despite the serious limitations of these studies.1-3 While more recent publications of […]
Malissa Mulkey, PhD, APRN, CCNS, CCRN Post-Doctoral Research Fellow, Indiana University Medical Center, Indianapolis, IN Based on the Diagnostic and Statistical Manual for Mental Disorders-Version 5 (DSM-V) delirium is defined as encompassing a reduction in attention, impairment in both cognition and memory and awareness.1 Historically, due to the high prevalence in the intensive care setting, […]
Leah Acker, MD, PhD, Assistant Professor of Anesthesiology, Duke University Medical Center, Durham, NC Outside of the delirium field, less complex physiological output signals often are associated with increased risk of geriatric syndromes. For example, an increased risk of falls is associated with less complex musculoskeletal adjustment movements.1 Overall, less complex physiological signals are associated […]
Matthew S. Duprey, PharmD, PhD, BCCCP Investigator, Department of Health Services, Policy, and Practice, Brown University School of Public Health Practitioners familiar with delirium and its consequences have long sought a medication-based treatment to reduce its severity and duration in hospital and also improve post-hospitalization outcomes including long-term cognitive impairment. Despite three randomized controlled trials […]
Contributed by Elizabeth Mahanna-Gabrielli, MD Department of Anesthesiology, Miller School of Medicine, University of Miami, Miami, Florida As a neuroanesthesiologist and intensivist, I’ve seen many frail patients come into the operating room and intensive care unit. During the early years of my career, frailty was informally defined as patient who was elderly, weak, and deconditioned; clinicians […]
Contributed by Brian O’Gara MD MPH Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA Postoperative delirium occurs in 15-50% of older surgical patients, and increases the risk of postoperative complications, hospital mortality and long-term cognitive dysfunction.1 Hospital -based multicomponent interventions can prevent postoperative delirium, but these approaches are only 30-40% effective.2 Therefore, there is […]