Contributed by Jessica Spence, MD, PhD, Population Health Research Institute, McMaster University, Hamilton, Canada Q: What was your rationale for conducting the B-Free trial? A: Low-quality evidence suggests that benzodiazepine administration after cardiac surgery in the ICU increases the risk of delirium and, as a result, several guidelines recommend benzodiazepines be avoided after cardiac surgery, […]
Contributed by John W. Devlin, PharmD1 and Frederick Sieber, MD2 1Northeastern University/Brigham and Women’s Hospital, Boston, MA 2Johns Hopkins School of Medicine, Baltimore, MD Question: Why did NIDUS embark on developing recommendations to advance delirium treatment trials? Answer: Delirium affects 1 in 5 older hospitalized adults, yet treatment strategies remain limited. Currently, delirium treatment focuses […]
Contributed by Yonah Joffe1, MS, Tamara G. Fong, MD, PhD2,3, and Eva M. Schmitt, PhD3 1Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA 2Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA 3Aging Brain Center, Marcus Institute for Aging Research Hebrew SeniorLife, Boston, MA, USA Introduction […]
Contributed by Matthew F. Mart, MD, MSCI1 and Timothy D. Girard, MD, MSCI2 1 Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN 2 Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA Background Delirium is common during critical illness and is associated with higher mortality, longer […]
Contributed by Michele Cavallari, MD, PhD, Center for Neurological Imaging, Brigham and Women’s Hospital; Harvard Medical School; and Marcus Institute for Aging Research, Hebrew SeniorLife; Boston, MA. Rationale and Objective Postoperative delirium is a common acute confusional state, affecting up to half of older surgical patients [1] and is an established independent risk factor for […]
Contributed by Mark van den Boogaard, RN, PhD, Radboud University Medical Center, Nijmegen, the Netherlands Background Delirium is common in intensive care unit (ICU) and medium care unit (MCU) settings 1, 2 and associated with number of deleterious short and long-term outcomes, including long-term cognitive impairment. Current guidelines recommend that ICU/MCU patients should be routinely […]
Contributed by Olivier Huet, MD, PhD, Université de Bretagne Occidentale, Brest, France. Background Postoperative delirium is acknowledged to have a significant negative impact on patient outcome after cardiac surgery including long-term cognitive decline. To date, there is no specific treatment for postoperative delirium 1. Prevention of postoperative delirium primarily relies on patient re-orientation, mobility and […]
Contributed by Angela Chen, BA1, 2; Robert Whittington, MD1; Cecilia Canales, MD, MPH1. 1. Department of Anesthesiology and Perioperative Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 2. Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA Background Older adults are highly vulnerable to postoperative delirium, particularly […]
Contributed by Noa Mintz, ScB, Brown University, Providence, RI and Michael Reznik, MD, Department of Critical Care Medicine & Neurology, University of Pittsburgh, Pittsburgh, PA Background Patients with acute stroke are at a high risk for delirium, which may occur in up to half of cases depending on the type of stroke.1–4 However, post-stroke delirium […]
Contributed by Kyra O’Brien MD and Mark Neuman MD MSc, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Background The impact of general anesthesia on postoperative outcomes in patients with cognitive impairment is often debated. Some have posited that general anesthesia may have neurotoxic effects and therefore increase the risk of postoperative delirium and […]