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Cited by 141Intensive Care Unit Cognitive DisordersAnesthesia and Sedative AgentsNosocomial Infections in ICU

The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.

Delirium as detected by the CAM-ICU predicts restraint use among mechanically ventilated medical patients*

Micek, Scott T., Anand, Nitin J., Laible, Brad R., Shannon, William D., Kollef, Marin H.·2005·Critical Care Medicine
DOI 10.1097/01.ccm.0000164540.58515.bf
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Abstract

OBJECTIVE: The first goal of this investigation was to identify individuals with delirium defined by the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) among medical patients with respiratory failure. Our second goal was to compare clinical interventions including use of continuous sedation infusions, the number of ventilator-free days, ICU length of stay, hospital mortality, and use of physical restraints in mechanically ventilated patients with and without delirium. DESIGN: A prospective, single-center, observational cohort study. SETTING: The medical intensive care unit (19 beds) of an urban teaching hospital. PATIENTS: Adult, intubated, and mechanically ventilated patients. INTERVENTIONS: Daily evaluation with the CAM-ICU, outcomes assessment, and prospective data collection. MEASUREMENTS AND MAIN RESULTS: Among 93 patients evaluated using the CAM-ICU, 44 patients (47%) developed delirium (CAM-ICU+) for >/=1 day while in the intensive care unit. Twenty-two patients (24%) had no episodes of delirium recorded (CAM-ICU-), and 27 (29%) remained comatose until extubation or death. A statistically greater number of patients with delirium (CAM-ICU+) received continuous infusions of midazolam (59% vs. 32%, p < .05) or fentanyl (57% vs. 32%, p < .05) and physical soft-limb restraints (77% vs. 50%, p < .05) compared with patients without delirium (CAM-ICU-). CONCLUSIONS: The identification of delirium using the CAM-ICU was associated with greater use of continuous sedation infusions and physical restraints. Additional studies are required to determine how the use of these specific interventions influences the occurrence and the natural history of delirium among critically ill patients.

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Crossref · 10.1097/01.ccm.0000164540.58515.bf

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Research works printed but not linked: 1

  1. Dolan, 2001, J Gerontol Med Sci, 55A, M527

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Metadata

Authors
Micek, S. T., Anand, N. J., Laible, B. R., Shannon, W. D., & Kollef, M. H.
Affiliations
Barnes-Jewish Hospital (US)
ORCID
Kollef, Marin H.
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-06
Volume
33
Issue
6
Pages
1260-1265
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/01.ccm.0000164540.58515.bf
OpenAlex
W2145882151
Cited by
141
References
29
Citations by year
2026: 1 · 2025: 5 · 2024: 1 · 2022: 5 · 2021: 12 · 2020: 6 · 2019: 6 · 2018: 10 · 2017: 5 · 2016: 9 · 2015: 7 · 2014: 11 · 2013: 10 · 2012: 15
FWCI
4.67
Type
journal article
Language
en
Open access
closed
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
delirium, CAM-ICU, physical restraint, mechanical ventilation, medical intensive care unit, continuous sedation, midazolam, fentanyl, respiratory failure, ventilator-free days, ICU length of stay, in-hospital mortality, comatose patients
MeSH terms
Adult, Aged, Analgesics, Opioid, Delirium, Female, Fentanyl, Humans, Hypnotics and Sedatives, Length of Stay, Male, Midazolam, Middle Aged, Missouri, Prospective Studies, Psychiatric Status Rating Scales, Respiration, Artificial, Restraint, Physical, Incidence, Hospital Mortality

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