The Vanderbilt group have just published the results of the feasibility trial MIND - Modifying the INcidence of Delirium in Critical Care Medicine. It is important because it was a placebo trial comparing ICU delirium duration using haloperidol, ziprasidone and placebo. While there was no difference between the groups it demonstrated safety and feasibility of such a study. The doors are open for a larger trial powered for meaningful outcomes.
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Now it is your opportunity to comment on the draft NICE guidelines on delirium. To contribute you or your organisation will need to be registered as stakeholders - a formality.
The draft guidelines with information about how to give feedback can be found at the NICE website:
www.nice.org.uk
The comments proforma should be emailed to delirium@nice.org.uk
You have until Wednesday 6 January but no time like the present!
Vanderbilt Medical Center where Professor Wes Ely works have a 2 minute video about his work into long-term cognitive impairment and ICU delirium in their news section. Check it out!
The Norfolk, Suffolk & Cambridgeshire Critical Care Network are hosting a study day , Thursday 19th November with presentations on restraint and a “How we implemented delirium screening, (warts ‘n all)” as well as the detection, prevention and treatment of ICU delirium.
Details at http://www.nsc-ccn.nhs.uk/
Its in Little Abingdon in Cambridge and costs £35 out of network. To register ring the network on 01603 866402 or email mandybaker@nhs.net.
See you there!
The question often asked is how screening for ICU delirium will help our patients? After all we do not yet know for sure if treating delirium will improve outcomes (the study is yet to be done, watch this space). Look up an article in press on the American Journal of Respiratory and Critical Care Medicine website; Margaret Pisani and her group in Yale have shown duration of ICU delirium was significantly associated with time to death within one year post-ICU admission. Knowing when your patient develops delirium makes good clinical sense!
www.ajrccm.atsjournals.org/cgi/content/abstract/200904-0537OCv1
The European Delirium Congress is in Leeds this October 8th and 9th - what an opportunity! Full details from the website: www.europeandeliriumassociation.com
If you work with critically ill children you would be forgiven for thinking that delirium is uncommon. There is certainly little in the literature about ICU delirium in children. However it is thought that it may be unrecognised rather than not present. Want to know more? There is a good review of what is known to date in Critical Care Clinics - “Delirium: An Emerging Frontier in the Management of Critically Ill Children”.
www.criticalcare.theclinics.com/article/S0749-0704(09)00041-4/abstract
The International Delirium Congress will be held in Leeds this year, October 8th and 9th. The programme is just being finalised and will be available on the European Delirium Association website (see link on the left hand menu). They have just opened the call for abstracts so now is your chance to share your work:-
“We now invite abstracts for oral presentations and posters. The deadline is
24th August 2009. Please provide a structured abstract (intro, methods,
results, discussion), with details of subject numbers, statistical tests,
etc., if applicable. Please indicate if you wish the abstract to be
considered for oral presentation and/or poster, or just for a poster.
Finally, indicate if you are happy that the abstracts be posted on the EDA
website.
All abstract submissions should be sent to: europeandelirium@gmail.com AND
a.maclullich@ed.ac.uk (this can be in the same email). An acknowledgement
will be sent within one week.”
In Critical Care there have been a couple of ICU delirium papers published recently so you might consider visiting the site. Dexmedetomidine has been compared with haloperidol to treat agitated delirium in a non-blinded pilot study. There is a commentary to accompany it, hopefully giving you something to think about.
The programme is currently being finalised for the International Delirium Congress which is being held in Leeds this year, so no excuses! Its on October 8th and 9th. There will be a signifcant amount of time set aside to workshops or masterclasses which were very popular last year in Helsinki. Book your study leave now.
Go to the European Delirium Association website (there is a link on the home page) for the latest information.