Active clinical trials for "Delirium"

Delirium is a common disorder in hospitalized patients, nevertheless it is poorly recognized by physicians and nurses, even when screening instruments are used. Electroencephalography (EEG) appears to be a sensitive tool for the diagnosis of delirium. However, standard EEG recording with 25 electrodes is labor intensive. We have previously showed that a brief EEG registration with three electrodes and automatic processing can distinguish patients with delirium from patients without delirium very well. However, these findings need to be validated in an unselected population. The primary objective of this validation study is to investigate the sensitivity, specificity, and predictive values of the EEG-based delirium monitor (including three electrodes and a reference electrode) compared to delirium quantification in frail elderly patients after surgery. In an international multicenter study, 154 frail elderly patients will be included who will undergo elective surgery and are expected to remain admitted for at least two postoperative days. Patients are excluded if communication is not possible or admitted for neurological surgery. A five minute EEG registration with the delirium monitor with four electrodes will be performed prior surgery and three consecutive days after surgery or until discharge. Within one hour of the EEG recording, the delirium assessment will be performed and recorded on video, which will be evaluated by delirium experts. The relative delta power (calculated from one minute of artifact-free EEG segment) will be compared with the conclusion of the delirium experts.

Despite recent advances in postoperative delirium research, the proportion of children with postoperative delirium is still high. Although postoperative delirium is a frequent complication and is associated with the need for more inpatient hospital care and longer length of hospital stay, little is known about risk factors for recovery room delirium (RRD) occurred in postanaesthesia care unit. The aim of the study was to determine pre- and intraoperative risk factors for the development of RRD among children undergoing non cardiovascular surgery.

Patients with the APOE-ε4 genotype are at increased risk of both vascular dementia and peripheral vascular disease. Patients undergoing major vascular surgery are at particularly high risk of delirium and other, more subtle, changes in cognitive function following surgery. The hypothesis of this trial is that the APOE-ε4 genotype is associated with both delirium and postoperative cognitive dysfunction (POCD).

Primary Objectives: To determine the proportion of patients who experience partial or complete recollection of symptoms of delirium and the level of distress associated with this recall. To determine caregiver's level of distress associated with the patient's episode of delirium.

ICU delirium are assessed by clinical nurses twice every day. Delirious patients are matched with patients according to their disease, gender and age range(±3 years). Stool samples for gene sequencing are collected. Gut barrier function are studied with several serum biomarkers (endotoxin, etc.). Ecological analyses, regression models and mediation equation will be performed.

In intensive care unit (ICU) patients, the ability to predict delirium may help reduce its incidence, duration, and severity. The PREdiction of DELIRium in ICU (PRE-DELIRIC) model was recently developed for this purpose. Our aim was to test the PRE-DELIRIC model in the medical ICU.

this study examines the incidence of newly developed delirium in patients who admit to university hospital stroke unit for cerebral infarction, and analyze the association between delirium motor subtypes and short-term outcome in post-stroke delirium patients.

Background: Physical restraint of patients in the intensive care unit (ICU) is a common practice, with estimated prevalence of 50% of all ICU patients, with and without invasive ventilation support(1). The prevalence of physical restraint varies between ICU's according to patient population (surgical, cardiac, trauma, burns and general intensive care patients). In mechanically ventilated patients, the physical restriction (tying the patient) is carried out frequently in addition to pharmacological treatment with analgesic and sedative medications, in order to prevent falling, self-inflicted injury or accidental removal of essential medical devices (tracheobronchial tubes, central venous infusions, drains, etc.) by the patient. In non-ventilated patients, physical restraint is often carried out in patients with delirium or cognitive decline, in addition to pharmacological anti -delirium therapy (1). However, physical restraint has many drawbacks, including injuries to the skin and the soft tissues, blood vessels, peripheral nerves, muscle and skeleton (2). In addition, physical restraint may exacerbate symptoms of restlessness and delirium and even increase the risk of developing post-traumatic stress disorder in these patients (3,4). Despite the high prevalence of physical restraint of ICU patients, with its disadvantages and advantages, currently there are no consensual criteria for physical restraint and the decision when and how long to use it is at the discretion of the attending physician. It is important to note that in recent years there has been a tendency to reduce the amount of sedation that mechanically ventilated patients are given, which may lead to an increase in the incidence of physical restraint of patients who are fully or partially conscious (5).

Delirium in the pediatric intensive care unit (PICU) is a serious problem that has recently attracted much attention. This study will evaluate the use of electroencephalogram (EEG) for delirium screening in the PICU.

70 children (based on the inclusion and exclusion criteria described above) admitted in PICU will be daily assessed by two nurses (inter-evaluator agreement) using the Italian version of CAPD scale administered twice at a distance of 2 minutes (intra-evaluator agreement).