Early Cognitive Intervention in Delirium
DeliriumCognitive Decline1 moreThis is a randomized control trial to determine if early cognitive training and rehabilitation improve 4-month cognition in hospitalized older (>=65 years old) delirious patients with and without Alzheimer's disease and related dementias. Enrolled patients will be randomized to receive cognitive intervention versus usual care at a 1:2 allocation ratio. Patients assigned to the cognitive intervention group will receive cognitive training daily during hospitalization and cognitive rehabilitation weekly for 12 weeks after hospital discharge. Patients will be evaluated for global cognition (primary outcome) and secondary outcomes at 4-months.
VR Interventions to Reduce the Prevalence of Delirium in ICU Patients
DeliriumDelirium is an extremely common complication in mechanically ventilated ICU patients, which can decrease the patients' cognitive function, prolong hospitalization, and even increase mortality. But there is currently no validated treatment for delirium. Therefore, this study aims to build a multi-modal virtual reality (VR) intervention environment to conduct comprehensive interventions in psychological, physiological, and cognitive aspects for ICU mechanically intubated patients, which will be used to improve the hospitalization experience, reduce the prevalence of delirium, and decrease the duration of ICU stay of patients on mechanical ventilation.
Namsos Anaesthesia Children Outcome Study
Emergence DeliriumBehavioral disturbances are often seen in children after anesthesia both immediately after surgery (emergence delirium) and after discharge from hospital. Persisting behavioral changes may affect emotional and cognitive development. It is known that both type of surgery and anesthetic management affect the occurrence of behavioral disturbances. Specifically, differences in occurrence were found after sevoflurane anesthesia and propofol anesthesia, two anesthetics that are generally used in practice. However, evidence is based on methodologically weak studies. The described occurrence of behavioral disturbances in children after anesthesia is not in line with the investigators' clinical experience, and neither are the described differences in occurrence between sevoflurane anesthesia and propofol anesthesia. This study will compare emergence delirium and behavioral changes after discharge from hospital in children who had surgery for removal of their tonsils under sevoflurane anesthesia versus propofol anesthesia.
Decreasing Preoperative Stress to Prevent Postoperative Delirium and Postoperative Cognitive Decline...
Preoperative StressPostoperative Cognitive Dysfunction1 morePatients undergoing cardiac surgery often complain of anxiety before a major operation and the resulting stress. This circumstance is a risk factor for mental problems that may occur after the operation (e.g., delirium or memory deficits). This study aims to prevent these discomforts by a preoperative relaxation intervention.
Antibiotics for Delirium in Older Adults With No Clear Urinary Tract Infection
Infectious DiseaseDelirium is an acute confusional state that is experienced by many older adults who are admitted to hospital. To treat delirium the underlying cause needs to be identified promptly, but this is challenging. One of the potential causes of delirium is infection. Urine tests show that most patients experiencing delirium have bacteria in their urine, however, bacteria in the urine is common among older adults, and does not automatically indicate an infection is present. As a result it is difficult to know whether a lower urinary tract infection is present as individuals with delirium are frequently unable to report clinical signs of infection - symptoms of pain or discomfort with urination, having to urinate more frequently or pelvic discomfort. Very often, individuals with delirium are treated with antibiotics despite the fact that it is unknown whether antibiotics help to improve delirium in cases where bacteria in the urine is present. This proposed study is a randomized controlled trial that will examine if adults (age 60 or older) with delirium and suspected infection benefit from taking antibiotics.
Different Anesthetic Strategies on Postoperative Cognitive Function and Delirium in Patients Undergoing...
DeliriumCondition1 moreThis is a prospective, multi-center, double-blind, randomized clinical trials.
Prevention of Delirium in ICU Using Multimodal Interventions
Intensive Care Unit DeliriumThis study was designed to evaluate the impact of non-pharmacological multimodal interventions including ongoing orientation, sensory correction, setting of familiar circumstance and promotion of sleep enviromnet for prevention of delirium in intensive care unit.
Low-dose Droperidol for Prevention of Postoperative Delirium in Elderly Patients After Non-cardiac...
Digestive System DiseaseUrologic Diseases2 moreThe aim of this multicenter, prospective, randomized, double-blind and large sample study is to explore the preventive effect of low-dose droperidol on POD in elderly patients after non-cardiac surgery, providing new approach for reducing the incidence of POD and improving the prognosis and quality of life.
Cerebrolysin in Prevention of Postoperative Delirium in Cardiac Surgery
Neurocognitive DisordersSurgery-Complications3 morePostoperative delirium (POD) and postoperative neuropsychological dysfunction are frequently noted in critically ill patients undergoing elective or emergency surgery and treated in the intensive care unit (ICU). Delirium is a serious complication that prolongs hospital stay and contributes to poor outcomes and increased risk of death. The pathomechanisms of delirium are still not very well recognized and there are several theories that seem to explain it. The most important pathomechanisms of delirium are associated with cerebral ischaemia, disorders in acetylcholinergic system, disorders in neuronal plasticity and oxidative stress. Cerebrolysin, a mixture of various peptides obtained from the structural proteins of the pig's brain, possesses strong antioxidative and neuronal protective properties. Cerebrolysin is recommended to treat patients with dementia, after cerebral ischemia and after brain trauma. It has been documented that Cerebrolysin reduces the severity of secondary brain damage after ischemia, improving neuronal plasticity and then cognitive function, and reducing severity of oxidative stress. Based on these properties it can be speculated that Cerebrolysin may reduce the risk of postoperative delirium in patients undergoing elective surgery, which are associated with a high risk of postoperative delirium.
Dexmedetomidine Supplemented Analgesia and Delirium After Hip Fracture Surgery
ElderlyHip Fracture Surgery3 moreDelirium is common in the elderly after hip fracture surgery, and is associated with worse outcomes. The investigators hypothesize that, for elderly patients after hip fracture surgery, dexmedetomidine supplemented analgesia can reduce the incidence of delirium and improve the long-term outcomes.