EEG changes and serum anticholinergic activity measured in patients with delirium in the intensive care unit

Anaesthesia

Volumn 62, Issue 12, 2007, Pages 1217-1223

  Plaschke, K ^a   Hill, H ^a   Engelhardt, R ^a   Thomas, C ^a,b   Von Haken, R ^a   Scholz, M ^a   Kopitz, J ^a   Bardenheuer, H J ^a   Weisbrod, M ^a,c   Weigand, M A ^a  

^a UNIVERSITY OF HEIDELBERG   (Germany)

^b EVANGELISCHES KRANKENHAUS   (Germany)

^c SRH Klinikum   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ANTICHOLINERGIC EFFECT; ARTICLE; BLOOD ANALYSIS; CLINICAL ARTICLE; CONTROLLED STUDY; DELIRIUM; ELECTROENCEPHALOGRAPHY; FEMALE; HUMAN; INTENSIVE CARE UNIT; MALE; MULTIVARIATE ANALYSIS OF VARIANCE;

AGED; BIOLOGICAL MARKERS; CHOLINERGIC ANTAGONISTS; DELIRIUM; ELECTROENCEPHALOGRAPHY; FEMALE; HUMANS; INTENSIVE CARE UNITS; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; SEVERITY OF ILLNESS INDEX; SIGNAL PROCESSING, COMPUTER-ASSISTED;

EID: 35848955423     PISSN: 00032409     EISSN: 13652044     Source Type: Journal    
DOI: 10.1111/j.1365-2044.2007.05255.x     Document Type: Article

References (38)

1. Gallinat J, Moller H, Moser RL, Hegerl U. Postoperative delirium: risk factors, prophylaxis and treatment. Anaesthesist 1999 48 : 507 18.
2. Wacker P, Nunes PV, Cabrita H, Forlenza OV. Post-operative delirium is associated with poor cognitive outcome and dementia. Dementia and Geriatric Cognitive Disorders 2006 21 : 221 7.
3. McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: occurrence and clinical course in older patients. Journal of the American Geriatrics Society 2003 51 : 591 8.
4. Dasgupta M, Dumbrell AC. Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. Journal of the American Geriatrics Society 2006 54 : 1578 89.
5. Brenner RP. Utility of EEG in delirium: past views and current practice. International Psychogeriatrics 1991 3 : 211 29.
6. Thomas C, Hestermann U, Walther S, et al. Prolonged activation EEG differentiates dementia with and without delirium in frail elderly. J of Neurology, Neurosurgery and Psychiatry 2007. Epub ahead of print.
7. Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. Journal of Neuropsychiatry and Clinical Neuroscience 1999 11 : 190 208.
8. Todorova A, Vonderheid-Guth B, Dimpfel W. Effects of tolterodine, trospium chloride, and oxybutynin on the central nervous system. Journal of Clinical Pharmacology 2001 41 : 636 44.
9. Niedermeyer E. The clinical relevance of EEG interpretation. Clinical Electroencephalography 2003 34 : 93 8.
10. Tune LE, Damlouji NF, Holland A, Gardner TJ, Folstein MF, Coyle JT. Association of postoperative delirium with raised serum levels of anticholinergic drugs. Lancet 1981 2 : 651 3.
11. Golinger RC, Peet T, Tune LE. Association of elevated plasma anticholinergic activity with delirium in surgical patients. American Journal of Psychiatry 1987 144 : 1218 20.
12. Tune L, Carr S, Cooper T, Klug B, Golinger RC. Association of anticholinergic activity of prescribed medications with postoperative delirium. Journal of Neuropsychiatry and Clinical Neuroscience 1993 5 : 208 10.
13. Flacker JM, Wei JY. Endogenous anticholinergic substances may exist during acute illness in elderly medical patients. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001 56 : M353 5.
14. Carnahan RM, Lund BC, Perry PJ, Pollock BG. A critical appraisal of the utility of the serum anticholinergic activity assay in research and clinical practice. Psychopharmacological Bulletin 2002 36 : 24 39.
15. Stagno D, Gibson C, Breitbart W. The delirium subtypes: a review of prevalence, phenomenology, pathophysiology, and treatment response. Palliative and Supportive Care 2004 2 : 171 9.
16. Trzepacz PT. The neuropathogenesis of delirium. Psychosomatics 1994 4 : 374 91.
17. Trzepacz PT. Is there a final common neural pathway in delirium? Focus on acetylcholine and dopamine. Seminars in Clinical Neuropsychiatry 2000 5 : 132 48.
18. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). Journal of the American Medical Association 2001 286 : 2703 10.
19. Tune L, Coyle JT. Serum levels of anticholinergic drugs in treatment of acute extrapyramidal side effects. Archives of General Psychiatry 1980 37 : 293 7.
20. Jacobson SA, Leuchter AF, Walter DO. Conventional and quantitative EEG in the diagnosis of delirium among the elderly. Journal of Neurology, Neurosurgery and Psychiatry 1993 56 : 153 8.
21. Koponen H, Partanen J, Paakkonen A, Mattila E, Riekkinen PJ. EEG spectral analysis in delirium. Journal of Neurology, Neurosurgery and Psychiatry 1989 52 : 980 5.
22. Reischies FM, Neuhaus AH, Hansen ML, Mientus S, Mulert C, Gallinat J. Electrophysiological and neuropsychological analysis of a delirious state: the role of the anterior cingulate gyrus. Psychiatry Research 2005 138 : 171 81.
23. Pisani MA, Araujo KL, Van Ness PH, Zhang Y, Ely EW, Inouye SK. A research algorithm to improve detection of delirium in the intensive care unit. Critical Care 2006 10 : R121.
24. Milbrandt EB, Angus DC. Bench-to-bedside review: Critical illness-associated cognitive dysfunction - mechanisms, markers, and emerging therapeutics. Critical Care 2006 10 : 238.
25. Nebes RD, Pollock BG, Mulsant BH, et al. Low-level serum anticholinergicity as a source of baseline cognitive heterogeneity in geriatric depressed patients. Psychopharmacology Bulletin 1997 33 : 715 20.
26. Miller PS, Richardson JS, Jyu CA, Lemay JS, Hiscock M, Keegan DL. Association of low serum anticholinergic levels and cognitive impairment in elderly presurgical patients. American Journal of Psychiatry 1988 145 : 342 5.
27. Mussi C, Ferrari R, Ascari S, Salvioli G. Importance of serum anticholinergic activity in the assessment of elderly patients with delirium. Journal of Geriatric Psychiatry and Neurology 1999 12 : 82 6.
28. Mach JR Jr., Dysken MW, Kuskowski M, Richelson E, Holden L, Jilk KM. Serum anticholinergic activity in hospitalized older persons with delirium: a preliminary study. Journal of the American Geriatrics Society 1995 43 : 491 5.
29. Tune LE, Egeli S. Acetylcholine and delirium. Dementia and Geriatric Cognitive Disorders 1999 10 : 342 4.
30. Lu CJ, Tune LE. Chronic exposure to anticholinergic medications adversely affects the course of Alzheimer disease. American Journal of Geriatric Psychiatry 2003 11 : 458 61.
31. Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. Journal of the American Medical Association 1990 263 : 1097 101.
32. Gaudreau JD, Gagnon P, Roy MA, Harel F, Tremblay A. Psychoactive medications and risk of delirium in hospitalized cancer patients. Psychosomatics 2005 46 : 302 16.
33. Korak-Leiter M, Likar R, Oher M, et al. Withdrawal following sufentanil/propofol and sufentanil/midazolam. Sedation in surgical ICU patients: correlation with central nervous parameters and endogenous opioids. Intensive Care Medicine 2005 31 : 380 7.
34. Sloan EP, Fenton GW, Standage KP. Anticholinergic drug effects on quantitative electroencephalogram, visual evoked potential and verbal memory. Biological Psychiatry 1992 31 : 600 6.
35. Thienhaus OJ, Allen A, Bennett JA, Chopra YM, Zemlan FP. Anticholinergic serum levels and cognitive performance. European Archives of Psychiatry and Clinical Neuroscience 1990 240 : 28 33.
36. Kay GG, Abou-Donia MB, Messer WS Jr., Murphy DG, Tsao JW, Ouslander JG. Antimuscarinic drugs for overactive bladder and their potential effects on cognitive function in older patients. Journal of the American Geriatrics Society 2005 53 : 2195 201.
37. Granberg AAI, Malmros CW, Bergbom IL, Lundberg DB. Intensive care unit syndrome/delirium is associated with anaemia, drug therapy and duration of ventilation treatment. Acta Anaesthesiologica Scandinavica 2002 46 : 726 31.
38. Joosten E, Lemiengre J, Nelis T, Verbeke G, Milisen K. Is anaemia a risk factor for delirium in an acute geriatric population? Gerontology 2006 52 : 382 5.