Journal ArticleDOI
European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium
Cesar Aldecoa,Gabriella Bettelli,Federico Bilotta,Robert D. Sanders,Riccardo A. Audisio,Anastasia Borozdina,Antonio Cherubini,Christina Jones,Henrik Kehlet,Alasdair M.J. MacLullich,Finn M. Radtke,Florian Riese,Arjen J.C. Slooter,Francis Veyckemans,Sylvia Kramer,Bruno Neuner,Bjoern Weiss,Claudia Spies +17 more
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TLDR
This guideline is aimed to promote knowledge and education in the preoperative, intraoperative and postoperative setting not only among anaesthesiologists but also among all other healthcare professionals involved in the care of surgical patients.Abstract:
The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoperative detection of delirium and management of delirious patients. The scope of this guideline is not to cover ICU delirium. Considering that many medical disciplines are involved in the treatment of surgical patients, a team-based approach should be implemented into daily practice. This guideline is aimed to promote knowledge and education in the preoperative, intraoperative and postoperative setting not only among anaesthesiologists but also among all other healthcare professionals involved in the care of surgical patients.read more
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Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial.
Troy S. Wildes,Angela M. Mickle,Arbi Ben Abdallah,Hannah R. Maybrier,Jordan Oberhaus,Thaddeus P. Budelier,Alex Kronzer,Sherry L. McKinnon,Daniel Park,Brian A. Torres,Thomas J. Graetz,Daniel A. Emmert,Ben J.A. Palanca,Shreya Goswami,Katherine Jordan,Nan Lin,Bradley A. Fritz,Tracey W. Stevens,Eric Jacobsohn,Eva M. Schmitt,Sharon K. Inouye,Susan Stark,Eric J. Lenze,Michael S. Avidan +23 more
TL;DR: Among older adults undergoing major surgery, EEG- guided anesthetic administration, compared with usual care, did not decrease the incidence of postoperative delirium, and this finding does not support the use of EEG-guided anesthetic Administration for this indication.
Journal ArticleDOI
Pre-operative evaluation of adults undergoing elective noncardiac surgery: Updated guideline from the European Society of Anaesthesiology.
Stefan De Hert,Sven Staender,Gerhard Fritsch,Jochen Hinkelbein,Arash Afshari,Gabriella Bettelli,Matthias Bock,Michelle S Chew,Mark Coburn,Edoardo De Robertis,Hendrik Drinhaus,Aarne Feldheiser,Götz Geldner,Daniel Lahner,Andrius Macas,Christopher Neuhaus,Simon Rauch,Maria Angeles Santos-Ampuero,Maurizio Solca,Nima Tanha,Vilma Traskaite,Gernot Wagner,Frank Wappler +22 more
TL;DR: The European Society of Anaesthesiology (ESA) guidelines on pre-operative evaluation of the adult undergoing noncardiac surgery are updated in this article, with recommendations based on the available relevant clinical evidence.
Journal ArticleDOI
Cognitive Trajectories After Postoperative Delirium
Jane S. Saczynski,Edward R. Marcantonio,Lien Quach,Tamara G. Fong,Alden L. Gross,Sharon K. Inouye,Richard N. Jones +6 more
TL;DR: In this article, the authors examined postoperative delirium and the cognitive trajectory during the first year after cardiac surgery and found a significant decline in cognitive ability, with a trajectory characterized by an initial decline and prolonged impairment.
Journal ArticleDOI
Postoperative delirium: perioperative assessment, risk reduction, and management
Zhaosheng Jin,Jie Hu,Daqing Ma +2 more
TL;DR: It is proposed that risk assessment and perioperative risk reduction may be the most effective approaches in managing postoperative delirium.
Journal ArticleDOI
Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms
Miles Berger,Niccolò Terrando,S. Kendall Smith,Jeffrey N. Browndyke,Mark F. Newman,Joseph P. Mathew +5 more
TL;DR: The authors discuss pathophysiologic mechanisms that may underlie these complications, review the literature on methods to prevent them, and discuss novel approaches to understand their etiology that may lead to novel treatment strategies.
References
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The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons
TL;DR: This study evaluated a modified, timed version of the “Get‐Up and Go” Test (Mathias et al, 1986) in 60 patients referred to a Geriatric Day Hospital and suggested that the timed “Up & Go’ test is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time.
Journal ArticleDOI
Grading quality of evidence and strength of recommendations.
David C. Atkins,Dana Best,Peter A. Briss,Martin P Eccles,Yngve Falck-Ytter,Signe Flottorp,Gordon H. Guyatt,Robin Harbour,Margaret C Haugh,David Henry,Suzanne Hill,Roman Jaeschke,Gillian Leng,Alessandro Liberati,Nicola Magrini,James Mason,Philippa Middleton,Jacek Mrukowicz,Dianne L. O'Connell,Andrew D Oxman,Bob Phillips,Holger J. Schünemann,Tessa Tan-Torres Edejer,H. Varonen,Gunn Elisabeth Vist,John W Williams,Stephanie Zaza +26 more
TL;DR: A system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts is developed, and a summary of the approach from the perspective of a guideline user is presented.
Journal ArticleDOI
Clarifying Confusion: The Confusion Assessment Method: A New Method for Detection of Delirium
TL;DR: The CAM is sensitive, specific, reliable, and easy to use for identification of delirium and was shown to have convergent agreement with four other mental status tests, including the Mini-Mental State Examination.
Journal ArticleDOI
Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit
Juliana Barr,Gilles L. Fraser,Kathleen Puntillo,E. Wesley Ely,Céline Gélinas,Joseph F. Dasta,Judy E. Davidson,John W. Devlin,John P. Kress,Aaron M. Joffe,Douglas B. Coursin,Daniel Herr,Avery Tung,Bryce R.H. Robinson,Dorrie K. Fontaine,Michael A. E. Ramsay,Richard R. Riker,Curtis N. Sessler,Brenda T. Pun,Yoanna Skrobik,Roman Jaeschke +20 more
TL;DR: These guidelines provide a roadmap for developing integrated, evidence-based, and patient-centered protocols for preventing and treating pain, agitation, and delirium in critically ill patients.
Journal ArticleDOI
The Richmond Agitation-Sedation Scale Validity and Reliability in Adult Intensive Care Unit Patients
Curtis N. Sessler,Mark S. Gosnell,Mary Jo Grap,Gretchen M. Brophy,Pam V. O'Neal,Kimberly A. Keane,Eljim P. Tesoro,Ronald K. Elswick +7 more
TL;DR: RASS has high reliability and validity in medical and surgical, ventilated and nonventilated, and sedated and nonsedated adult ICU patients and is described as logical, easy to administer, and readily recalled.