Pathophysiology
This neurotransmitter plays an important role in memory and cognition. Therefore a decrease in levels of this neurotransmitter in the brain would be expected in patients presenting with delirium.
Acetylcholine
Delirium goes unrecognized by clinicians ____% of the time.
What is 70%?
Vast majority of patients fall into the __________ delirium subtype
What is hypoactive delirium?
What are some non-pharmacological approaches to managing symptoms of delirium?
What are sleep normalization, reorientation, family engagement, early mobilization, and reducing sensory deprivation?
The symptoms of inattention and decreased cognitive functioning observed in patients with delirium are associated with this change in cerebral blood flow
decreased cerebral blood flow
Before assessing the content of consciousness for delirium, clinicians should first evaluate this using tools such as the RASS.
What is arousal or level of consciousness?
The sub-type for restlessness, constant movement, agitation, insomnia and hyper-vigilance is ______________
What is hyperactive delirium?
These medications, often used to treat agitation in the ICU, may worsen cognition and exacerbate delirium.
What are benzodiazepines and narcotics?
The neuroinflammatory hypothesis of delirium is supported by the clinical evidence that patients with post-operative delirium have ______________
higher circulating blood levels/blood plasma levels of inflammatory cytokines than patients without delirium
In pediatric ICU patients, clinicians commonly use this screening tool, which was administered using the ABADBADAAY attention test.
What is the Pediatric Confusion Assessment Method for the ICU (pCAM-ICU)?
This hallmark symptom is the cognitive deficit most characteristic of delirium.
What is impaired attention?
Current PADIS guidelines recommend this medication for mechanically ventilated adults whose agitation from delirium prevents extubation.
What is dexmedetomidine?
This neurotransmitter is thought to be increased in delirium and contributes to hallucinations and agitation.
What is dopamine?
What are the four diagnostic criteria for Delirium?
Disturbance of consciousness, a change in cognition or the development of a perceptual disturbance. The disturbance develops over a short period of time and tends to fluctuate during the day and there is evidence that the disturbance is caused by the physiological consequences of a medication condition
Hallucinations, delusions, and disorientation are examples of this broad symptom domain affected in delirium.
What is cognition?
This vitamin supplementation should be considered in all patients with delirium.
What is thiamine?
Why is it that dopamine antagonists can effectively treat some symptoms associated with delirium?
Dopamine has an inhibitory effect on acetylcholine release. Therefore, a dopamine antagonist will not allow dopamine to inhibit the release of acetylcholine
What are some non-pharmacological approaches to managing symptoms of delirium?
Creating a calm, comfortable environment with the use of orienting influences such as calendars, clocks and familiar objects from home. Regular reorienting communication with staff, involving the family and supportive care and limiting room and staff changes
Up to this percentage of pediatric ICU patients may experience delirium.
What is 40%?
According to current guidelines, these medications are generally not recommended for routine treatment of delirium but may be used short-term for severe distressing symptoms.
What are haloperidol and atypical antipsychotics?