Delirium duration and mortality in lightly sedated, mechanically ventilated intensive care patients

Critical Care Medicine

Volumn 38, Issue 12, 2010, Pages 2311-2318

  Shehabi, Yahya ^a   Riker, Richard R ^b   Bokesch, Paula M ^c   Wisemandle, Wayne ^c   Shintani, Ayumi ^d   Ely, E Wesley ^d  

^a UNIVERSITY OF NEW SOUTH WALES   (Australia)

^b MAINE MEDICAL CENTER   (United States)

^c Vanderbilt University ^*

^d VANDERBILT UNIVERSITY   (United States)

Author keywords

critically ill; delirium; delirium duration; mechanical ventilation; mortality; sedation

Indexed keywords

DEXMEDETOMIDINE; MIDAZOLAM;

ADULT; AROUSAL; ARTICLE; ARTIFICIAL VENTILATION; CONTINUOUS INFUSION; DELIRIUM; DISEASE DURATION; DOSE RESPONSE; EXTUBATION; FEMALE; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORTALITY; OUTCOME ASSESSMENT; PREDICTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; SEDATION;

EID: 78650305502     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3181f85759     Document Type: Article

References (50)

1. Ely EW, Siegel MD, Inouye SK: Delirium in the intensive care unit: An under-recognized syndrome of organ dysfunction. Semin Re-spir Crit Care Med 2001; 22:115-126
2. Pisani MA, Murphy TE, Van Ness PH, et al: Characteristics associated with delirium in older patients in a medical intensive care unit. Arch Intern Med 2007; 167:1629-1634
3. Ouimet S, Kavanagh BP, Gottfried SB, et al: Incidence, risk factors and consequences of ICU delirium. Intensive Care Med 2007; 33: 66-73
4. Patel RP, Gambrell M, Speroff T, et al: Delirium and sedation in the intensive care unit: Survey of behaviors and attitudes of 1384 healthcare professionals. Crit Care Med 2009; 37:825-832
5. 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). JAMA 2001; 286:2703-2710
6. Pandharipande PP, Pun BT, Herr DL, et al: Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: The MENDS randomized controlled trial. JAMA 2007; 298: 2644-2653
7. Riker RR, Shehabi Y, Bokesch PM, et al: Dexmedetomidine vs midazolam for sedation of critically ill patients: A randomized trial. JAMA 2009; 301:489-499
8. Pandharipande P, Cotton BA, Shintani A, et al: Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma 2008; 65:34-41
9. Lat I, McMillian W, Taylor S, et al: The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Crit Care Med 2009; 37:1898-1905
10. Thomason JW, Shintani A, Peterson JF, et al: Intensive care unit delirium is an independent predictor of longer hospital stay: A prospective analysis of 261 non-ventilated patients. Critical Care 2005; 9:R375-R381
11. Pisani MA, Murphy TE, Araujo KL, et al: Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population. Crit Care Med 2009; 37: 177-183
12. Levkoff SE, Evans DA, Liptzin B, et al: Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients. Arch Intern Med 1992; 152:334-340
13. Girard TD, Jackson JC, Pandharipande PP, et al: Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med 2010; 38:1513-1520
14. Hopkins RO, Weaver LK, Collingridge D, et al: Two-year cognitive, emotional, and qual-ity-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med 2005; 171:340-347
15. Hopkins RO, Jackson JC: Long-term neuro-cognitive function after critical illness. Chest 2006; 130:869-878
16. Marcantonio ER, Kiely DK, Simon SE, et al: Outcomes of older people admitted to post-acute facilities with delirium. J Am Geriatr Soc 2005; 53:963-969
17. Inouye SK: Delirium in older persons. N Engl J Med 2006; 354:1157-1165
18. Kiely DK, Jones RN, Bergmann MA, et al: Association between delirium resolution and functional recovery among newly admitted postacute facility patients. J Gerontol A Biol Sci Med Sci 2006; 61:204-208
19. McNicoll L, Pisani MA, Zhang Y, et al: Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc 2003; 51:591-598
20. Milbrandt EB, Deppen S, Harrison PL, et al: Costs associated with delirium in mechanically ventilated patients. Crit Care Med 2004; 32:955-962
21. Franco K, Litaker D, Locala J, et al: The cost of delirium in the surgical patient. Psycho-somatics 2001; 42:68-73
22. Rompaey BV, Elseviers MM, Schuurmans MJ, et al: Risk factors for delirium in intensive care patients: A prospective cohort study. Crit Care 2009; 13:R77
23. Williamson JW, Wilson R: Assessing and improving health care outcomes. In: The Health Account Approach to Quality Assurance. Cambridge, MA, Ballinger Publishing, 1980
24. Ely EW, Shintani A, Truman B, et al: Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 204; 291:1753-1762
25. Ely EW, Gautam S, Margolin R, et al: The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 2001; 27:1892-1900
26. Pisani MA, Kong SY, Kasl SV, et al: Days of delirium are associated with 1-year mortality in older intensive care unit population. Am J Respir Crit Care Med 2009; 180: 1092-1097
27. Girard TD, Kress JP, Fuchs BD, et al: Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): A randomised controlled trial. Lancet 2008; 371:126-134
28. Kress JP, Pohlman AS, O'Connor MF, et al: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000; 342: 1471-1477
29. Sessler CN, Gosnell MS, Grap MJ, et al: The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med 2002; 166:1338-1344
30. Knaus WA, Draper EA, Wagner DP, et al: APACHE II: A severity of disease classification system. Crit Care Med 1985; 13: 818-829
31. Shintani AK, Girard TD, Eden SK, et al: Immortal time bias in critical care research: Application of time-varying Cox regression for observational cohort studies. Crit Care Med 2009; 37:2939-2945
32. Harrell FE: Regression modeling strategies, with applications to linear models, logistic regression, and survival analysis. Second Edition. New York, NY, Springer, 2005, p 20
33. Simon R, Makuch RW: A non-parametric graphical representation of the relationship between survival and the occurrence of an event: Application to responder versus non-responder bias. Stat Med 1984; 3:35-44
34. Mantel N, Byar DP: Evaluation of response-time data involving transient states: An illustration using heart-transplant data. J Am Stat Assoc 1974; 69:81-88
35. Payen JF, Chanques G, Mantz J, et al: Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patient-based study. Anesthesiology 2007; 106:687-695; quiz 891-892
36. Kress JP, Vinayak AG, Levitt J, et al: Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease. Crit Care Med 2007; 35:365-371
37. Schweickert WD, Kress JP: Strategies to optimize analgesia and sedation. Crit Care Med 2008; 12(Suppl 3):S6
38. Witlox J, Eurelings LSM, de Jonghe JFM, et al: Postdischarge mortality, institutionaliza-tion, and delirium in elderly patients and the risk of dementia: A meta-analysis. JAMA 2010; 304:443-451
39. Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psy-chol 1986; 51:1173-1182
40. Herridge MS, Batt J, Hopkins RO: The patho-physiology of long-term neuromuscular and cognitive outcomes following critical illness. Crit Care Clin 2008; 24:179 -199, x
41. Maldonado JR: Pathoetiological model of delirium: A comprehensive understanding of the neurobiology of delirium and an evidence-based approach to prevention and treatment. Crit Care Clin 2008; 24: 789-856, ix
42. Dubois MJ, Bergeron N, Dumont M, et al: Delirium in an intensive care unit: A study of risk factors. Intensive Care Med 2001; 27:1297-1304
43. Ouimet S, Riker R, Bergeron N, et al: Sub-syndromal delirium in the ICU: Evidence for a disease spectrum. Intensive Care Med 2007; 33:1007-1013
44. Van Gool WA, Van de Beek D, Eikelenboom P: Systemic infection and delirium: When cytokines and acetylcholine collide. Lancet 2010; 27:773-775
45. Shehabi Y, Grant P, Wolfenden H, et al: Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: A randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology 2009; 111: 1075-1084
46. Ruokonen E, Parviainen I, Jakob SM, et al: Dexmedetomidine versus propofol/midazolam for long-term sedation during mechanical ventilation. Intensive Care Med 2009; 35:282-290
47. Pandharipande P, Shintani A, Peterson J, et al: Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology 2006; 104:21-26
48. Schweickert WD, Pohlman MC, Pohlman AS, et al: Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial. Lancet 2009; 373:1874-1882
49. Sareli AE, Schwab RJ: The sleep-friendly ICU. Crit Care Clin 2008; 24:613-626, viii
50. Bone RC, Balk RA, Cerra FB, et al: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101:1644-655