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01.06.2010 | Commentary

The complex interplay between delirium, sepsis and sedation

verfasst von: John P Kress

Erschienen in: Critical Care | Ausgabe 3/2010

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Abstract

Critically ill patients requiring mechanical ventilation frequently suffer from intensive care unit delirium, a syndrome associated with numerous poor measured outcomes. The relationship between delirium, sepsis, and sedation is complex. A discussion of the recent study ('Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS [maximizing efficacy of targeted sedation and reducing neurological dysfunction] randomized controlled trial') by Pandharipande and colleagues is presented in this commentary.

Pandharipande PP, Sanders RD, Girard TD, McGrane S, Thompson JL, Shintani AK, Herr DL, Maze M, Ely EW, the MENDS investigators: Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori -designed analysis of the MENDS randomized controlled trial. Crit Care 2010, 14: R38. 10.1186/cc8916PubMedCentralCrossRefPubMed

Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, Inouye SK, Bernard GR, Dittus RS: Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004, 291: 1753-1762. 10.1001/jama.291.14.1753CrossRefPubMed

Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R: 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. 10.1001/jama.286.21.2703CrossRefPubMed

Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, Tesoro EP, Elswick RK: The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med 2002, 166: 1338-1344. 10.1164/rccm.2107138CrossRefPubMed

Ouimet S, Riker R, Bergeron N, Cossette M, Kavanagh B, Skrobik Y: Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007, 33: 1007-1013. 10.1007/s00134-007-0618-yCrossRefPubMed

Pisani MA, Kong SY, Kasl SV, Murphy TE, Araujo KL, Van Ness PH: Days of delirium are associated with 1-year mortality in an older intensive care unit population. Am J Respir Crit Care Med 2009, 180: 1092-1097. 10.1164/rccm.200904-0537OCPubMedCentralCrossRefPubMed

Pandharipande PP, Pun BT, Herr DL, Maze M, Girard TD, Miller RR, Shintani AK, Thompson JL, Jackson JC, Deppen SA, Stiles RA, Dittus RS, Bernard GR, Ely EW: 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. 10.1001/jama.298.22.2644CrossRefPubMed

Titel: The complex interplay between delirium, sepsis and sedation
verfasst von: John P Kress
Publikationsdatum: 01.06.2010
Verlag: BioMed Central
Erschienen in: Critical Care / Ausgabe 3/2010
Elektronische ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc9038

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