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Delirium diagnosis, screening and management

PURPOSE OF REVIEW: Our review focuses on recent developments across many settings regarding the diagnosis, screening and management of delirium, so as to inform these aspects in the context of palliative and supportive care. RECENT FINDINGS: Delirium diagnostic criteria have been updated in the long...

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Autores principales: Lawlor, Peter G., Bush, Shirley H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162328/
https://www.ncbi.nlm.nih.gov/pubmed/25004177
http://dx.doi.org/10.1097/SPC.0000000000000062
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author Lawlor, Peter G.
Bush, Shirley H.
author_facet Lawlor, Peter G.
Bush, Shirley H.
author_sort Lawlor, Peter G.
collection PubMed
description PURPOSE OF REVIEW: Our review focuses on recent developments across many settings regarding the diagnosis, screening and management of delirium, so as to inform these aspects in the context of palliative and supportive care. RECENT FINDINGS: Delirium diagnostic criteria have been updated in the long-awaited Diagnostic Statistical Manual of Mental Disorders, fifth edition. Studies suggest that poor recognition of delirium relates to its clinical characteristics, inadequate interprofessional communication and lack of systematic screening. Validation studies are published for cognitive and observational tools to screen for delirium. Formal guidelines for delirium screening and management have been rigorously developed for intensive care, and may serve as a model for other settings. Given that palliative sedation is often required for the management of refractory delirium at the end of life, a version of the Richmond Agitation-Sedation Scale, modified for palliative care, has undergone preliminary validation. SUMMARY: Although formal systematic delirium screening with brief but sensitive tools is strongly advocated for patients in palliative and supportive care, it requires critical evaluation in terms of clinical outcomes, including patient comfort. Randomized controlled trials are needed to inform the development of guidelines for the management of delirium in this setting.
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spelling pubmed-41623282014-09-19 Delirium diagnosis, screening and management Lawlor, Peter G. Bush, Shirley H. Curr Opin Support Palliat Care GENERAL SUPPORTIVE AND PALLIATIVE CARE: Edited by Eduardo Bruera PURPOSE OF REVIEW: Our review focuses on recent developments across many settings regarding the diagnosis, screening and management of delirium, so as to inform these aspects in the context of palliative and supportive care. RECENT FINDINGS: Delirium diagnostic criteria have been updated in the long-awaited Diagnostic Statistical Manual of Mental Disorders, fifth edition. Studies suggest that poor recognition of delirium relates to its clinical characteristics, inadequate interprofessional communication and lack of systematic screening. Validation studies are published for cognitive and observational tools to screen for delirium. Formal guidelines for delirium screening and management have been rigorously developed for intensive care, and may serve as a model for other settings. Given that palliative sedation is often required for the management of refractory delirium at the end of life, a version of the Richmond Agitation-Sedation Scale, modified for palliative care, has undergone preliminary validation. SUMMARY: Although formal systematic delirium screening with brief but sensitive tools is strongly advocated for patients in palliative and supportive care, it requires critical evaluation in terms of clinical outcomes, including patient comfort. Randomized controlled trials are needed to inform the development of guidelines for the management of delirium in this setting. Lippincott Williams & Wilkins 2014-09 2014-08-07 /pmc/articles/PMC4162328/ /pubmed/25004177 http://dx.doi.org/10.1097/SPC.0000000000000062 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle GENERAL SUPPORTIVE AND PALLIATIVE CARE: Edited by Eduardo Bruera
Lawlor, Peter G.
Bush, Shirley H.
Delirium diagnosis, screening and management
title Delirium diagnosis, screening and management
title_full Delirium diagnosis, screening and management
title_fullStr Delirium diagnosis, screening and management
title_full_unstemmed Delirium diagnosis, screening and management
title_short Delirium diagnosis, screening and management
title_sort delirium diagnosis, screening and management
topic GENERAL SUPPORTIVE AND PALLIATIVE CARE: Edited by Eduardo Bruera
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162328/
https://www.ncbi.nlm.nih.gov/pubmed/25004177
http://dx.doi.org/10.1097/SPC.0000000000000062
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